Cutaneous ulcerations caused by Paecilomyces variotii in a renal transplant recipient.

Skin infections caused by Paecilomyces species have been rarely described in patients with solid organ transplantation. Cutaneous manifestations are highly variable and include erythematous macules, nodules, pustules, and vesicular and necrotic lesions. The diagnosis of these infections is generally made by examination of a skin biopsy. Management of these fungal infections is difficult due to the immunocompromised state of the patients. Moreover, antifungal therapy and immunosuppressive drug interactions should be considered during treatment management. Herein, we reported a case of cellulitis caused by Paecilomyces variotii in a 56-year-old man who had undergone a kidney transplantation. Erythematous macular and nodular lesions on the left hand and left foot appeared first; within 2 months the skin lesions became ulcerated, hemorrhagic, and progressively painful and the patient was admitted to our hospital. The diagnosis was made by skin biopsy and tissue culture. The skin lesions resolved by the sixth week of the treatment with voriconazole.

Treatment of Paecilomyces variotii pneumonia with posaconazole: case report and literature review.

The fungi Paecilomyces variotii is a potential pathogen in immunocompromised and immunocompetent patients. Their rare association with clinical disease results in scarce literature regarding susceptibility and treatment. Here, we discuss a case involving successful treatment of probable P. variotii pneumonia with posaconazole after treatment failure with voriconazole. The current literature related to antifungal susceptibility profiles, microbiological identification methods and clinical management of infections caused by this organism is also reviewed.

Successful treatment of Paecilomyces variotii peritonitis in a liver transplant patient.

Paecilomyces variotii has previously been reported as a causative pathogen for peritonitis in patients on continuous ambulatory peritoneal dialysis and shown to be usually sensitive to amphotericin B and resistant to voriconazole. We report the first case, to our knowledge, of P. variotii peritonitis in a liver transplant patient, which was unresponsive to initial liposomal amphotericin B (L-AmB) treatment and resolved dramatically after the addition of voriconazole. The present case provides evidence for the clinical and microbiological effectiveness of voriconazole combined with L-AmB in treating P. variotii peritonitis refractory to initial L-AmB treatment.

A Comparative Study on the Biosorption of Cd2+ onto Paecilomyces lilacinus XLA and Mucoromycote sp. XLC.

The filamentous fungi XLA and XLC isolated from Cd-contaminated soil were identified morphologically and phylogenetically as Paecilomyces lilacinus and Mucoromycote sp., respectively. The minimum inhibitory concentrations (MICs) of Cd2+, Co2+, Cu2+, Zn2+, Cr3+ and Cr6+ in minimum mineral (MM) medium agar plates were 29,786, 2945, 9425, 5080, 1785 and 204 mg · L(-1) for XLA and 11,240, 884, 9100, 2540, 3060 and 51 mg · L(-1) for XLC, respectively. Favorable biosorption conditions for adsorption of Cd2+ by the tested fungi were investigated. Efficient performances of the biosorbents were described using Langmuir isotherm model, and the predicted maximum biosorption capacities for Cd2+ were 77.61 mg · g(-1) of XLA and 79.67 mg · g(-1) of XLC. Experiments on desorption potential of biosorbents validated their efficacy at a large scale. Results showed that XLA obtained a desorption rate of 84.7% by 2% EDTA and XLC gained a desorption rate of 78.9% by 0.1 M HCl. Analysis by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS) and X-ray photoelectron spectroscopy (XPS) suggested that groups of C-N, COO- for XLA and C-N, CH2 and phosphate for XLC were the dominant binding sites for Cd2+ biosorption. Our results indicated that the fungus XLA, rather than XLC, could potentially be used as an inexpensive, eco-friendly and effective bioremediation agent for the removal of Cd2+ from wastewater.

Toxicology of Graphene Oxide Nanosheets Against Paecilomyces catenlannulatus.

Graphene oxide (GO) nanosheets have been extensively investigated to fabricate the graphene in recent years. The migration of GO nanosheets into the environment could lead to the instability of biological system. In this study, the GO nanosheets were synthesized and were characterized by SEM, high resolution TEM, XRD, Raman, FTIR and XPS techniques. Toxicology testing of GO nanosheets against Paecilomyces catenlannulatus (P. catenlannulatus) was performed by measuring the efflux of cytoplasmic materials of P. catenlannulatus. Approximate 35 % of the bacteria could survive on the surface of GO nanosheets compared to the control sample (~92 %) within 3 h, indicating that GO nanosheets presented significantly antibacterial activities. It was observed that the concentration of RNA in the solution was obviously higher than that of control sample, which could be due to direct contact of the bacterial cell. The results showed that the damage of cell membrane of P. catenlannulatus was attributed to the direct contact of the P. catenlannulatus with the extremely sharp edges of GO nanosheets, which resulted in the P. catenlannulatus inactivation. The less resistant to the damage of cell membrane was observed with increasing of GO concentration and contact time.

[Pulmonary paecilomycosis: Diagnosis and treatment].

AIM: To represent the advances of Russia and Uzbekistan in studying the problem of paecilomycosis. The goal of the investigation was to develop the diagnosis and treatment of pulmonary paecilomycosis (PP). SUBJECTS AND METHODS: Two hundred and twenty-five people, including 200 patients with bronchopulmonary infection with fungi of the Paecilomyces genus and 25 clinically healthy individuals (a control group), were examined. Clinico-anamnestic, laboratory diagnostic, mycological, and immunological studies were conducted; a lymphocyte antigen-binding test was used for differential diagnosis. Paecilomyces infection was diagnosed by microscopically examining the morphology of the fungi in the pathological material (blood, sputum) and by isolating the cultured fungi in the media (Sabouraud's and Czapek's ones). The severe complication of PP - atypical paecilomycosis-associated myocarditis (APAM) - was studied in 112 patients with helminthiasis-complicated paecilomycosis. These patients underwent using the conventional echocardiography. RESULTS: Bronchopulmonary paecilomycosis resulting from primary and secondary infection with fungi of the Paecilomyces genus was clinically manifested as chronic obstructive bronchitis (11.5%), recurrent pneumonia (13.5%), exogenous allergic alveolitis (37%), and asthma (26%) complicated by helminthiasis (12%). Iodine deficiency promotes the prevalence of paecilomycosis and echinococcosis favors Paecilomycosis infection; moreover, the helminth capsule itself serves as a nutrient medium for the development of the mycelial form of the fungus. APAM is a severe complication of PP. Almost 50% of the patients with PP presented with carditis. The patients with APAM occasionally experienced fear and the most severe intermittent pain. The latter first occurred in the chest.and irradiated to the axilla, left hand, and its fingertips, paralyzing the arm. In some patients, the pain manifested itself in both arms with abdominal irradiation, by being accompanied by faints. Current analgesics (meloxicam, tizanidine, nimesulide, morphine, promedole) in combination with fluconazole provided a temporary positive effect. CONCLUSION: Further investigations that must also include neurologists and anesthetists are required to work out effective pain relief regimens for APAM in patients with PP.

Relationship between antimold activity and molecular structure of cinnamaldehyde analogues.

A quantitative structure-activity relationship (QSAR) modeling of the antimold activity of cinnamaldehyde analogues against of Aspergillus niger and Paecilomyces variotii was presented. The molecular descriptors of cinnamaldehyde analogues were calculated by the CODESSA program, and these descriptors were selected by best multi-linear regression method (BMLR). Satisfactory multilinear regression models of Aspergillus niger and Paecilomyces variotii were obtained with R(2)=0.9099 and 0.9444, respectively. The models were also satisfactorily validated using internal validation and leave one out validation. The QSAR models provide the guidance for further synthetic work.

Effects of external calcium on the biotransformation of ginsenoside Rb1 to ginsenoside Rd by Paecilomyces bainier 229-7.

Calcium is a known signalling molecule in eukaryotic cells and plays a central role in the regulation of many cellular processes. In the following study, we report on the effect of external calcium treatments on the biotransformation of ginsenoside Rb1 to ginsenoside Rd by Paecilomyces bainier 229-7. We observed that the intracellular calcium content of P. bainier 229-7 mycelia was increased in response to exposure to high external Ca(2+) concentrations. Both ginsenoside Rd biotransformation and ß-glucosidase activity were both found to be dependent on the external calcium concentration. At an optimal Ca(2+) concentration of 45 mM, maximal ginsenoside Rd bioconversion rate of 92.44% was observed and maximal ß-glucosidase activity of 0.1778 U was reached in a 72-h biotransformation. The Ca(2+) channel blocker Verapamil blocked the trans-membrane influx of calcium and decreased ginsenoside Rd biotransformatiom. In addition, ß-glucosidase activity and ginsenoside Rd content decreased by 36.0 and 29.2% respectively after a 72-h incubation in the presence of 0.05 mM Calmodulin (CaM) antagonist Perphenazine. These results suggest that both Ca(2+) channels and CaM are involved in ginsenoside Rd biotransformation via regulation of ß-glucosidase activity. This is the first report regarding the effects of calcium signal transduction on biotransformation and enzyme activity in fungi.

[Cardiac involvement in adults with echinococcosis].

Experiments have established that the first target for echinococcus is the liver and lung and that for pathogenic fungi and protozoa is the heart. Adult patients with hepatic hydatid disease complicated by paecilomycosis have been found to have atypical paecilomycosis-associated myocarditis, the treatment of which was developed by the authors, by using antibiotics, fungicides, and homeopathic remedies.

In vitro activity of E1210, a novel antifungal, against clinically important yeasts and molds.

E1210 is a new antifungal compound with a novel mechanism of action and broad spectrum of antifungal activity. We investigated the in vitro antifungal activities of E1210 compared to those of fluconazole, itraconazole, voriconazole, amphotericin B, and micafungin against clinical fungal isolates. E1210 showed potent activities against most Candida spp. (MIC(90) of ≤0.008 to 0.06 µg/ml), except for Candida krusei (MICs of 2 to >32 µg/ml). E1210 showed equally potent activities against fluconazole-resistant and fluconazole-susceptible Candida strains. E1210 also had potent activities against various filamentous fungi, including Aspergillus fumigatus (MIC(90) of 0.13 µg/ml). E1210 was also active against Fusarium solani and some black molds. Of note, E1210 showed the greatest activities against Pseudallescheria boydii (MICs of 0.03 to 0.13 µg/ml), Scedosporium prolificans (MIC of 0.03 µg/ml), and Paecilomyces lilacinus (MICs of 0.06 µg/ml) among the compounds tested. The antifungal action of E1210 was fungistatic, but E1210 showed no trailing growth of Candida albicans, which has often been observed with fluconazole. In a cytotoxicity assay using human HK-2 cells, E1210 showed toxicity as low as that of fluconazole. Based on these results, E1210 is likely to be a promising antifungal agent for the treatment of invasive fungal infections.

Synchronous infection with Mycobacterium chelonae and Paecilomyces in a heart transplant patient.

A 41-year-old male who was 3 years status post heart transplant presented with a 3-month history of painful erythematous nodules and ulcers on his lower legs and right hand. First, Mycobacterium chelonae infection was revealed through several biopsies with molecular sequence analysis, and combination treatment, including clarithromycin, was started. During the treatment, lesions of the legs showed an improvement, but a fluctuant erythematous nodule on the thumb did not respond. Repetitive biopsy from the thumb ultimately identified Paecilomyces species and the patient was treated with itraconazole and terbinafine sequentially. Our case is the first report, to our knowledge, of synchronous infection with non-tuberculous mycobacteria (NTM) and Paecilomyces in a solid organ transplant recipient. Our findings highlight the importance of recognizing cutaneous NTM infections or deep mycoses, as well as the importance of choosing an appropriate treatment.

Cutaneous hyalohyphomycosis caused by Paecilomyces lilacinus successfully treated by oral voriconazole and nystatin packing.

Paecilomyces lilacinus causes multiple diseases in humans, especially in immunocompromised patients. Cutaneous infections are the second most commonly encountered circumstance. We describe a woman with liver cirrhosis with hemorrhagic, bullous, ulcerative leg lesions caused by Paecilomyces lilacinus. The lesions improved after treatment with oral voriconazole and topical nystatin powder. We also reviewed previously reported cases of cutaneous P. lilacinus infection that were treated by oral voriconazole.

[Amino acid exchange in paeci lomycosis-complicated echinococcosis].

The authors have detected atypical paecilomycosis-associated myocarditis with impaired amino acid exchange and pain syndrome for the first time. At first, pain occurs in the chest and radiates into the axilla, to the left arm to the finger tips, by paralyzing the arm. In some patients, pain manifests itself in both arms with radiation to the belly, by accompanying by fainting. The skin is wet, cold; the pulse is frequent and of poor volume and difficult-to-count. Heart pain spreads into the armpit and down the arm, by making the fingers numb. Attempts to use current analgesics (movalis, sirdalud, nimesil, morphine) in combination with fungicides (diflucan, mycosist, orungal) have failed to yield positive results. The homeopathic drug Latrodectus mactans, prepared from caracurt venom, in combination with the authors' designed diet and other homeopathic agents have relieved pain syndrome and normalized amino acid exchange, which offered possibilities for successful surgical treatment for echinococcosis with later recovery.

Fungus-benzimidazole interactions: a prerequisite to deploying egg-parasitic fungi Paecilomyces lilacinus and Verticillium chlamydosporium as biocontrol agents against fascioliasis and amphistomiasis in ruminant livestock.

In vitro trials investigating the effects of albendazole and triclabendazole anthelmintics on the growth profiles of the egg-parasitic fungi Paecilomyces lilacinus and Verticillium chlamydosporium were undertaken. In addition, in vivo trials were conducted in goats fed on millet grain cultures of each fungus and administered albendazole and triclabendazole anthelmintics. In vitro growth revealed V. chlamydosporium to be more sensitive to albendazole compared to P. lilacinus. In contrast, triclabendazole had the least inhibitory effect on in vitro growth of both P. lilacinus and V. chlamydosporium. Similar to albendazole, growth of P. lilacinus was more vigorous at 0.5 ppm concentration of triclabendazole. Efforts to re-isolate these egg-parasitic fungi from faeces of goats fed on fungal millet grain cultures before and following single intraruminal administration of albendazole and triclabendazole showed that P. lilacinus was not able to be re-isolated from the faeces at any sampling period. In contrast, V. chlamydosporium was able to be re-isolated from the faeces at all of the sampling periods except for the samples taken at 8-18 h and 18-24 h after administration of albendazole and triclabendazole, respectively. Lack of fungal activity at these times coincided with peak plasma availability of anthelmintics and suggests faecal levels of drugs were also high at these times and impacted negatively on fungal viability.

Comparison of electrolized water and multiple chemical sanitizer action against heat-resistant molds (HRM).

This study aimed to evaluate the sensitivity of heat-resistant molds isolated from spoiled thermally processed foods to antimicrobial compounds used for food industry sanitation. An ortho-phenylphenol-based smoke generator sanitizer, liquid chemical sanitizers (benzalkonium chloride, biguanide, iodine, peracetic acid, and sodium hypochlorite), and acidic and alkaline electrolyzed water were used against Aspergillus australensis (MB 2579; NFF 02), Aspergillus aureoluteus (NFC1), Paecilomyces fulvus (PFF 01), Paecilomyces niveus (PNT 01; PNDC 01; PNB1 01), and Paecilomyces variotii (PV 01; PV 01; PVCH 03). The fungal strains were exposed separately to liquid sanitizers and electrolyzed water in stainless steel discs for 15 min following the European Committee for Standardization (CEN) recommendations. Moreover, the fungal strains were exposed to the smoke generator sanitizer for 7 h following French protocol NF-T-72281. The best results of fungal inactivation were achieved when the highest concentration specified in the label of these sanitizers was tested. On the opposite, the lowest concentration specified in the label should be avoided since it was ineffective in most cases (94%). The ortho-phenyphenol-based smoke generator sanitizer and peracetic acid (1%) showed the best results of spore inactivation, while iodine and benzalkonium chloride achieved satisfactory results against the strains evaluated. Sodium hypochlorite and biguanide were ineffective against most of the fungi studied at all concentrations tested. Acidic and basic electrolyzed water was also ineffective to achieve the 3-log CFU reduction required in the concentrations tested. In general, Paecilomyces spp. was more sensitive than Aspergillus spp. against all sanitizers evaluated, whereas A. aureoluteus NFC1 was resistant to all agents and concentrations tested. The heat-resistant fungal strains showed varied sensitivity against the different agents. Notably, the two most effective commercial sanitizers against the heat-resistant strains were ineffective against the filamentous fungi recommended for sanitizer testing (A. brasiliensis ATCC 16404), which demonstrates the relevance of testing fungal isolates that cause spoilage to choose the most effective compound and obtain the best results of fungal control.

Posaconazole efficacy in a murine disseminated infection caused by Paecilomyces lilacinus.

OBJECTIVES: We have compared the efficacy of posaconazole and amphotericin B in an experimental murine model of paecilomycosis. METHODS: Immunosuppressed mice were treated with posaconazole at 25, 50, 75 or 100 mg/kg/day orally, amphotericin B at 1.5 or 3 mg/kg/day intraperitoneally or liposomal amphotericin B at 5 mg/kg/day intravenously. Treatment began 1 day after infection and continued for 10 days post-infection. Two strains of Paecilomyces lilacinus were tested. RESULTS: Posaconazole at 50 mg/kg/day was the only treatment able to significantly reduce fungal loads in the spleens, kidneys and livers of the mice infected by each of the two strains. CONCLUSIONS: The results suggest that posaconazole may have a clinical role in the treatment of disseminated paecilomycosis.

Physiological effect of multi-walled carbon nanotubes (MWCNTs) on conidia of the entomopathogenic fungus, Paecilomyces fumosoroseus (Deuteromycotina: Hyphomycetes).

The aim of the investigation was to assess the influence of commercial and carboxylated multi-walled carbon nanotubes (MWCNTs) on conidia of the entomopathogenic fungus Paecilomyces fumosoroseus. The commercial MWCNTs had an external diameter of about 40-60 nm, a length of 300-600 nm, a specific density of 140 to 300 g/dm(3) and a carbon content of above 80%. Carboxylated MWCNTs were obtained by oxidizing commercial MWCNT by heating in HNO(3), filtering, washing with water and drying. Conidia after different times of contact (from 1 to 865 hours) with nanomaterials in aqueous solutions were cultured for linear and biomass growth. Growth and sporification of mycelium after culture were evaluated. MWCNTs are not greatly cytotoxic for P. fumosoroseus conidia in the applied concentrations. The linear growth of mycelium obtained from conidia after contact with nanotubes was inhibited only in 2 (out of 18) cases (ones for both kinds of nanotubes). Carboxylated nanotubes did not inhibit biomass growth at all, but commercial nanotubes inhibited biomass growth in 2 cases. Sporification was the feature most strongly modified by carbon nanotubes. The commercial nanotubes again more strongly limited sporification of mycelium than carboxylated nanotubes did. The relatively greater influence of commercial versus carboxylated nanotubes was observed in the experiments.

Susceptibility testing and molecular classification of Paecilomyces spp.

In vitro susceptibility profiles of 58 Paecilomyces clinical isolates are reported. Amphotericin B, itraconazole, and echinocandins showed poor activity against Paecilomyces lilacinus, while the new triazoles were active against it. Paecilomyces variotii exhibited a different susceptibility pattern, being susceptible to most antifungal agents apart from voriconazole and ravuconazole.

Paecilomyces lilacinus peritonitis complicating peritoneal dialysis cured by oral voriconazole and terbinafine combination therapy.

Fungal peritonitis (FP) is a serious complication in patients on continuous ambulatory peritoneal dialysis (CAPD). We report a case of CAPD-related FP caused by Paecilomyces lilacinus in a 15-year-old uraemic boy. The infection was successfully treated by combination therapy consisting of oral voriconazole and terbinafine, which has not been previously reported in the treatment of FP.