Visceral Mycoses in Autopsied Cases in Japan from 1989 to 2013.

BACKGROUND AND METHODS: Our group has continuously studied the epidemiology of visceral mycoses (VM) among autopsy cases in Japan from 1989 to 2013. RESULTS: First, from a total of 11,149 autopsied cases, 571 (5.1%) cases of VM were observed in 2013. It was significantly higher than those of 2005 (p < 0.05) and earlier. Notably, incidence of cases with mucormycetes (Muc) in 2013 was higher than that of 1997 and earlier (p < 0.001), especially in leukemia cases. Muc cases also showed higher rate of "severe infection" compared with other cases (p < .0001). Emerging diseases were also observed. Severe fever with thrombocytopenia syndrome cases showed high incidence of VM as a complication. In addition, we observed cases with the rare mycoses caused by Phialopohra verrucosa and Rhodotorula spp. in our analysis. Moreover, the predominant fungal agent of central nervous system infections changed from Cryptococcus spp. to Aspergillus spp. in 2013. This may be considered a breakthrough infection. CONCLUSION: The prevalence of VM in 2013 became higher than those of 2005 (p < 0.05) and earlier, with a notable increase of incidence in cases with Muc. The occurrence of breakthrough VM and emerging mycoses deserve attention.

Dermatite fúngica associada à Rhodotorula glutinis em cão - Canis familiaris ): relato de caso / Fungal dermatitis associated to Rhodotorula glutinis in dog (Canis familiaris): case report

O fungo Rhodotorula sp. era considerado como não patogênico, mas, com o aumento de casos de humanos imunossuprimidos nas últimas duas décadas, as espécies R. mucilaginosa, R. glutinis e R. minuta se tornaram agentes potencialmente patogênicos. Poucos relatos clínicos veterinários associados à Rhodotorula spp. foram descritos, e o objetivo deste trabalho foi descrever um caso de dermatite fúngica causada por R. glutinis em cão imunossuprimido devido à leishmaniose visceral e osteossarcoma, na cidade de Cuiabá-Mato Grosso. Um cão, macho, 11 anos, sem raça definida, foi trazido ao Hospital Veterinário apresentando lesões de pele com diagnóstico de dermatofitose e foi prescrito tratamento tópico à base de óleo de melaleuca, sem melhora após um mês de tratamento. O animal retornou ao Hospital Veterinário com hemorragia na região lesionada da cauda, e foi realizada biópsia para exames microbiológico e histopatológico. Nas análises microbiológica e histopatológica, foi isolada uma levedura e detectada a presença de estrutura semelhante a leveduras na coloração de prata, respectivamente. A levedura isolada foi identificada como R. glutinis por meio do sequenciamento do DNA. Um novo tratamento foi instituído, sem melhora do quadro clínico. O animal foi diagnosticado também com leishmaniose e osteossarcoma, provavelmente ocasionando a immunossupressão, e seu quadro evoluiu a óbito.(AU)

The fungi Rhodotorula sp was considered nonpathogenic, but with the increase of immunosuppressed humans in the last two decades, the species R. mucilaginosa, R. glutinis and R. minuta became potentially pathogenic agents. There have been few veterinary clinical reports associated with Rhodotorula spp. and this work aims to describe the first case of fungal dermatitis caused by R. glutinis in immunosuppressed dog due to visceral leishmaniasis and osteosarcoma in the city of Cuiabá-Mato Grosso. An 11-year-old male mongrel dog was examined to the Veterinary Hospital with skin lesions and the diagnosis was dermatophytosis and the treatment was implemented with topical tea tree oil for one month, but the treatment failed. The animal returned to the Veterinary Hospital with bleeding in the injured area of the tail and biopsy was performed for microbiological and histopathology evaluation. In the microbiological and histopathological analysis, yeast was isolated and yeast-like structures in silver staining were observed, respectively. The isolated yeast was identified as R. glutinis by DNA sequencing. A new treatment was implemented without clinical improvement. The animal was diagnosed with leishmaniasis and osteosarcoma, which probably caused immunosuppression, and its clinical conditions evolved to death.(AU)

Probable fungemia por Rhodotorula mucilaginosa asociada a catéter venoso central en un paciente pediátrico: presentación de un caso / Probable fungemia by rhodotorula mucilaginosa associated to a central venous catheter in a pediatric pacient: a case report

Las levaduras del género Rhodotorula son patógenos oportunistas emergentes, especialmente en pacientes inmunocomprometidos. Se presenta el caso de un niño de 9 años con sarcoma de Ewing en tratamiento con quimioterapia que cursó con una probable fungemia por Rhodotorula mucilaginosa. Se identificaron varios factores de riesgo tales como la presencia de un catéter venoso central (CVC) y una neoplasia maligna sólida. El diagnóstico se realizó a través de un hemocultivo de una rama del CVC. Nuestra cepa fue identificada como R. Mucilaginosa por morfofisiología y pruebas bioquimicas. El éxito terapeutico se basó en el retiro del CVC y en el tratamiento con anfotericina B desoxicolato como primera alternativa.

Yeasts from Rhodotorula genus are opportunistic pathogen that emerge especially in immunocompromised patients. We report a case of a 9-years-old boy, he developed an Ewing’s sarcoma that was treated with chemotherapy an underwent with problable fungemia by Rhodotorula mucilaginosa. Several risk factors were identified such as presence of a central venous catheter (CVC) and a solid malignant neoplasm. The diagnosis was made by blood culture of a branch of the CVC. Our isolated was identified as R. mucilaginosa by morphofisiology and biochemical test. The therapy did success based on withdrawal of CVC and treatment with amphotericin B deoxycholate as the first alternative.

Central Venous Catheter-related Fungemia Caused by Rhodotorula glutinis.

Bloodstream infection due to Rhodotorula glutinis is extremely rare and mostly associated with underlying immunosuppression or cancer. Vascular access devices provide the necessary surfaces for biofilm formation and are currently responsible for a significant percentage of human infections. In this work, we describe a rare case of central venous catheter-related Rhodotorula glutinis fungemia in a female patient with acute myelogenous leukemia in remission. The timely removal of central venous catheter was an essential element for overcoming this CVC-related Rhodotorula fungemia.

Multifocal skeletal tuberculosis with Rhodotorula minuta co-infection.

Multifocal skeletal tuberculosis comprises lesions occurring at 2 or more locations of the skeleton. We present an atypical case of multifocal skeletal tuberculosis coexisting with Rhodotorula minuta infection in a non-immunocompromized host. The advantages of computed tomography-guided biopsy in establishing the diagnosis and thus influencing treatment are also discussed.

Aislamiento de Rhodotorula sp. en un paciente críticamente enfermo Descripción de un caso y revisión de la literatura / Rhodotorula sp. Isolate in a critically ill patient. Case report and review

Los reportes de infecciones micóticas diseminadasdebido a los miembros del orden criptococalesse han limitado al Cryptococcus y Candida. La Rhodotorula es una levadura encontrada en la piel, esputo y excretas de los seres humanos. Morfológica y bioquímicamente se caracteriza por producir un llamativo pigmento rojizo, no asimilar el inositol y tener ocasionalmente rudimentarios pseudomicelios (1-4). Las infecciones causadas por este agente soninfrecuentes en la práctica clínica. Algunos centrosespecializados en cáncer reportan series decasos en las décadas anteriores a 1980 (2).

Transient fungemia due to Rhodotorula rubra in a cancer patient: case report and review of the literature.

A unique case of Rhodotorula rubra transient fungemia in a post-chemotherapy, febrile neutropenic patient with colon cancer, suffering from gastrointestinal mucositis, is described. The fungus was isolated repeatedly from his blood. However, all signs and symptoms of the infection disappeared, without antifungal treatment, as soon as neutropenia and mucositis, both of short duration, resolved. Restoration of the patient's defense mechanisms was adequate for disappearance of the fungus from the patient's blood and full recovery.

Rhodotorula Rubra em cabelos humanos simulando quadro de piedra branca / Similar white piedra by Rodotorula rubra

Resumo: Rhodotorula rubra é levedura oportunista, esando associada a uma variedade de processos patológicos no homem, é frequêntemente encontrada como contaminante da pele, pulmäo, urina, fezes e sistema nervoso central e com grande significado quando presente no sangue. As determinantes humanas causadas por Rhodotorula têm sido relatadasmas näo documentadas. O presente trabalho relata pela primeira vez em nosso meio, o isolamento desse microrganismo, como agente etiológico de infecçäo de cabelos humanos que ao exame clínico, simula pidra branca. Cabelos apresentando nódulos claros foram colhidos de paciente com 18 anos de idade. Em seguida classificados com KOH a 20 (por cento) entre lâmina e lamínula e observados no microscópio óptico comum e na microscopia eletrônicade varredura. Os cabelos foram semeados em ágar Sabnouraud-glicose contendo 200 mg/l de clonranfenicol, incubados à 25 graus C por 5 dias. Após o isolamento da levedura, a mesma foi identificada utilizando-se técnicas micológicas usuais. O exame microscópico dos pêlos infectados revelou em algumas regiöes o aumento do volume do cabelo, característico da tricorrexe nodosa. Em outras regiöes os pêlos já se apresentavam fragmentados e, com relativa facilidade podia-se observar leveduras arredondadas com brotamento em base estreita. A microscopia eletrônica de varredura pode-se observar mais detalhadamente a descriçäo acima. A levedura isolada foi identificada como Rhodotorula rubra, sem atividade lipolítica. É importante ressaltar que a referida levedura foi isolada repetidas vezes em cultura pura dos cabelos infectados. Este achado clínicoe laboratorial deve seer considerado, assim como deve merecer a devida atençäo dos pesquisadoresos isolamentos de R. rubra os quais permitiräo um correto diagnóstico micológico e terapêutico adequada (au)