RESUMEN
Choanephora infundibulifera is a member of the Mucorales order of fungi. The species is associated with plants as a saprophyte or parasite and may be responsible for spoilage or disease but is an uncommon cause of human infection. We describe C. infundibulifera rhinosinusitis in a young man with leukemia in Tennessee, USA.
Asunto(s)
Sinusitis , Humanos , Masculino , Tennessee , Sinusitis/microbiología , Sinusitis/diagnóstico , Sinusitis/parasitología , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Mucormicosis/diagnóstico , Mucormicosis/microbiología , Mucormicosis/tratamiento farmacológico , Mucorales/aislamiento & purificación , Mucorales/clasificación , Rinitis/microbiología , Rinitis/diagnóstico , Adulto , Antifúngicos/uso terapéutico , RinosinusitisRESUMEN
Aspergillus species and Mucorales agents are the primary etiologies of invasive fungal disease (IFD). Biomarkers that predict outcomes are needed to improve care. Patients diagnosed with invasive aspergillosis and mucormycosis using plasma cell-free DNA (cfDNA) PCR were retested weekly for 4 weeks. The primary outcome included all-cause mortality at 6 weeks and 6 months based on baseline cycle threshold (CT) values and results of follow-up cfDNA PCR testing. Forty-five patients with Aspergillus and 30 with invasive Mucorales infection were retested weekly for a total of 197 tests. Using the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium (EORTC/MSG) criteria, 30.7% (23/75), 25.3% (19/75), and 38.7% (29/75) had proven, probable, and possible IFD, respectively. In addition, 97.3% (73/75) were immunocompromised. Baseline CT increased significantly starting at week 1 for Mucorales and week 2 for Aspergillus. Aspergillosis and mucormycosis patients with higher baseline CT (CT >40 and >35, respectively) had a nonsignificantly higher survival rate at 6 weeks, compared with patients with lower baseline CT. Mucormycosis patients with higher baseline CT had a significantly higher survival rate at 6 months. Mucormycosis, but not aspergillosis patients, with repeat positive cfDNA PCR results had a nonsignificantly lower survival rate at 6 weeks and 6 months compared with patients who reverted to negative. Aspergillosis patients with baseline serum Aspergillus galactomannan index <0.5 and <1.0 had significantly higher survival rates at 6 weeks when compared with those with index ≥0.5 and ≥1.0, respectively. Baseline plasma cfDNA PCR CT can potentially be used to prognosticate survival in patients with invasive Aspergillus and Mucorales infections. IMPORTANCE: We show that Aspergillus and Mucorales plasma cell-free DNA PCR can be used not only to noninvasively diagnose patients with invasive fungal disease but also to correlate the baseline cycle threshold with survival outcomes, thus potentially allowing the identification of patients at risk for poor outcomes, who may benefit from more targeted therapies.
Asunto(s)
Ácidos Nucleicos Libres de Células , ADN de Hongos , Infecciones Fúngicas Invasoras , Mucormicosis , Reacción en Cadena de la Polimerasa , Humanos , Mucormicosis/diagnóstico , Mucormicosis/mortalidad , Mucormicosis/sangre , Mucormicosis/microbiología , Masculino , Femenino , Persona de Mediana Edad , Pronóstico , Anciano , Ácidos Nucleicos Libres de Células/sangre , Reacción en Cadena de la Polimerasa/métodos , Adulto , ADN de Hongos/genética , ADN de Hongos/sangre , Infecciones Fúngicas Invasoras/diagnóstico , Infecciones Fúngicas Invasoras/mortalidad , Infecciones Fúngicas Invasoras/microbiología , Aspergillus/genética , Aspergillus/aislamiento & purificación , Aspergilosis/diagnóstico , Aspergilosis/mortalidad , Aspergilosis/microbiología , Mucorales/genética , Mucorales/aislamiento & purificación , Biomarcadores/sangre , Anciano de 80 o más Años , Estudios ProspectivosRESUMEN
An 8-y-old Pygora doe was presented to the University of California-Davis, Veterinary Medical Teaching Hospital because of non-healing facial swelling of 2-wk duration. The lesion grew despite medical treatment, causing discomfort masticating, little-to-no airflow from the right nasal passage, and led to euthanasia. On gross examination, a large facial mass with a draining tract through the skin and hard palate was identified. On section, the mass was brown-pink, homogeneous, and friable. Abscess-like masses were identified in the lungs and kidney. Histopathology of the face, including oral and nasal cavities, salivary glands, and lymph nodes, as well as the lung and kidney lesions, revealed large areas of necrosis with numerous wide ribbon-like, mostly aseptate, fungal hyphae consistent with zygomycetes. PCR for fungal organisms performed on formalin-fixed, paraffin-embedded tissue from the face identified Lichtheimia corymbifera (formerly Absidia corymbifera) of the order Mucorales and an Aspergillus sp. The lesion was suspected to have started either as a fungal rhinitis or dental feed impaction, subsequently spreading to the face and systemically to the lungs and kidney. We describe here the lesions associated with facial mucormycosis in a goat and present a literature review of L. corymbifera infection in veterinary species and fungal infections in goats.
Asunto(s)
Enfermedades de las Cabras , Cabras , Mucormicosis , Animales , Mucormicosis/veterinaria , Mucormicosis/patología , Mucormicosis/diagnóstico , Mucormicosis/microbiología , Enfermedades de las Cabras/microbiología , Enfermedades de las Cabras/patología , Cara/patología , Mucorales/aislamiento & purificación , Masculino , Absidia/aislamiento & purificaciónRESUMEN
Mucormycosis is a severe and emerging invasive fungal infection associated with high mortality rates. Early diagnosis is crucial for initiating specific antifungal treatment, with molecular tools currently representing the most efficient diagnostic approach. Presently, a standardized in-house real-time PCR method is widely employed for diagnosing mucormycosis. Our study aimed to evaluate the agreement for the Mucorales DNA detection between two commercial real-time PCR assays-the Fungiplex Mucorales Real-Time PCR Kit and the MycoGENIE Aspergillus-Mucorales spp. Real-Time PCR Kit-in comparison with the in-house PCR. We retrospectively analyzed 58 samples previously identified as positive for Mucorales using the in-house PCR. These samples, obtained from 22 patients with proven or probable mucormycosis, were tested with both commercial kits. Additionally, samples from 40 patients without mucormycosis served as negative controls. Our findings revealed that the MycoGENIE Kit demonstrated superior performance in detecting Mucorales DNA in samples identified as positive by the in-house PCR. Notably, we observed minimal variability in cycle threshold (CT) values when comparing the results of the MycoGENIE Kit with those of the in-house PCR, with an average difference of 1.8 cycles. In contrast, the Fungiplex Kit exhibited a larger discrepancy in CT values compared to the in-house PCR, with an average difference of 4.1 cycles. The MycoGENIE Kit exhibited very good agreement (kappa of 0.82) with the in-house PCR for detecting Mucorales DNA across various sample types. These findings are important for the choice of kits that could be used to diagnose mucormycosis in clinical microbiology laboratories. IMPORTANCE: Early diagnosis of mucormycosis is crucial for initiating effective treatment. The detection of Mucorales DNA by PCR in serum has revolutionized the diagnosis of this infection. However, the use of in-house methods can be time consuming. The availability of a commercial kit eliminates the need for in-house assay development, reducing laboratory workload and ensuring consistent performance across different healthcare settings. Currently, there are several commercial assays available, but many have limited evaluation. In this study, we compared two commercial kits and found that the MycoGENIE Kit offers a promising alternative to the in-house method.
Asunto(s)
ADN de Hongos , Mucorales , Mucormicosis , Juego de Reactivos para Diagnóstico , Reacción en Cadena en Tiempo Real de la Polimerasa , Mucormicosis/diagnóstico , Mucormicosis/microbiología , Humanos , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Mucorales/aislamiento & purificación , Mucorales/genética , Estudios Retrospectivos , Masculino , ADN de Hongos/genética , Femenino , Persona de Mediana Edad , Sensibilidad y Especificidad , Anciano , AdultoRESUMEN
This text discusses a rare case of soft tissue infection caused by the fungus Saksenaea in a young, immunocompetent woman following an all-terrain vehicle accident abroad. Despite initial treatment, her wound worsened, necessitating multiple surgical revisions and aggressive antifungal therapy with liposomal Amphotericin B. The interdisciplinary collaboration among orthopedic surgeons, infectious disease specialists, and plastic surgeons played a vital role in her successful treatment. Prompt identification of the fungus and immediate intervention were crucial. This case emphasizes the importance of awareness among healthcare providers regarding this rare condition and underscores the significance of early diagnosis and timely surgical and medical interventions for a positive outcome.
Asunto(s)
Anfotericina B , Antifúngicos , Inmunocompetencia , Humanos , Femenino , Antifúngicos/uso terapéutico , Anfotericina B/uso terapéutico , Accidentes de Tránsito , Mucormicosis/diagnóstico , Mucormicosis/tratamiento farmacológico , Infecciones de los Tejidos Blandos/microbiología , Infecciones de los Tejidos Blandos/tratamiento farmacológico , Infecciones de los Tejidos Blandos/diagnóstico , Infecciones Fúngicas Invasoras/tratamiento farmacológico , Infecciones Fúngicas Invasoras/diagnóstico , Adulto , Mucorales/aislamiento & purificaciónRESUMEN
Rhino-orbital-cerebral mucormycosis (ROCM) is linked to uncontrolled diabetes, diabetic ketoacidosis, iron overload, corticosteroid therapy, and neutropenia. This study evaluated a commercial real-time PCR system's effectiveness in detecting Mucorales from nasal swabs in 50 high-risk patients. Nasal swab PCR showed 30% positivity, compared to 8% with KOH microscopy. Despite its improved sensitivity, nasal swab PCR has limitations, highlighting the importance of established sampling methods in mucormycosis diagnosis. Participants were predominantly male (64%), with diabetes (78%) and amphotericin B use (96%). Prior COVID-19 was 42%, with 30% positive for Mucorales by PCR, compared to 8% with KOH microscopy.
Asunto(s)
Mucorales , Mucormicosis , Reacción en Cadena en Tiempo Real de la Polimerasa , Humanos , Mucormicosis/diagnóstico , Masculino , Femenino , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Mucorales/aislamiento & purificación , Mucorales/genética , Persona de Mediana Edad , Adulto , COVID-19/diagnóstico , Sensibilidad y Especificidad , Anciano , SARS-CoV-2/genética , SARS-CoV-2/aislamiento & purificaciónRESUMEN
During surge of COVID-19-associated mucormycosis (CAM), we identified five cases of CAM where two different species of Mucorales were isolated. All had history of diabetes mellitus and presented with clinical features suggesting rhino-orbital mucormycosis. The patients grew different species from their nasal scraping/biopsy samples, Rhizopus arrhizus, R. homothallicus (n = 2); R. homothallicus, Lictheimia corymbifera (n = 1); R. arrhizus, Mucor spp (n = 1); and L. corymbifera, Apophysomyces variabilis (n = 1). All patients underwent surgical and medical (liposomal amphotericin B) treatment. All, except one growing A. variabilis and L. corymbifera survived. Mixed infection by more than one Mucorales in CAM is unique and warrants epidemiological investigation.
Asunto(s)
COVID-19 , Mucorales , Mucormicosis , Mucormicosis/diagnóstico , Mucormicosis/microbiología , Humanos , Mucorales/aislamiento & purificación , Mucorales/clasificación , Masculino , Persona de Mediana Edad , COVID-19/complicaciones , Femenino , Antifúngicos/uso terapéutico , Anfotericina B/uso terapéutico , Adulto , SARS-CoV-2 , AncianoAsunto(s)
Artritis Infecciosa , Osteomielitis , Niño , Femenino , Humanos , Masculino , Artritis Infecciosa/microbiología , Artritis Infecciosa/tratamiento farmacológico , Artritis Infecciosa/diagnóstico , Mucorales/aislamiento & purificación , Mucormicosis/diagnóstico , Mucormicosis/tratamiento farmacológico , Mucormicosis/microbiología , Osteomielitis/microbiología , Osteomielitis/tratamiento farmacológico , Osteomielitis/diagnóstico , MicronesiaRESUMEN
Background: Mucormycosis is a fungal infection caused by species of the Mucorales order. These microorganisms are angioinvasive, with rapid disease progression and potentially lethal in its rhinocerebral form. Case report: We present the case of a 12-year-old female with trisomy 21, acute lymphoblastic leukemia and diabetes, with fever and neutropenia who developed rhinocerebral mucormicosis. After treatment with amphotericin B lipid complex and extensive surgery, disease progressed and posaconazole was added as salvage treatment with full remission of the infection. Four years after diagnosis the patient continues without relapse of mucormycosis or leukemia. Conclusions: This case highlights the use of posaconazole as either monotherapy or combined therapy. Although it is still debated, it can be considered an option for salvage treatment in children with non-responding mucormycosis, despite lack of standard dosage in pediatric patients
Antecedentes: La mucormicosis es una infección fúngica causada por especies del orden de los mucorales. Estos microorganismos se caracterizan por ser angioinvasivos, con progresión rápida de la enfermedad y potencialmente letales en la forma rinocerebral. Caso clínico: Presentamos el caso de una paciente de 12 años de edad con trisomía 21, leucemia linfoblástica aguda, diabetes, fiebre y neutropenia, que desarrolló una mucormicosis rinocerebral. La enfermedad progresó a pesar de recibir tratamiento con anfotericina B complejo lipídico y ser sometida a cirugía extensa. Se añadió posaconazol al tratamiento como terapia de salvamento, lo que llevó a la remisión total del proceso infeccioso. Cuatro años después la paciente continúa sin recaída de la mucormicosis o la leucemia. Conclusiones: Este caso destaca el uso del posaconazol, ya sea como monoterapia o terapia combinada en el tratamiento de la mucormicosis. Si bien aún es debatido su uso, se puede considerar como una opción en el tratamiento de niños con mucormicosis que no responden al tratamiento convencional a pesar de no contar con una dosis pediátrica establecida
Asunto(s)
Humanos , Femenino , Niño , Mucormicosis/tratamiento farmacológico , Mucorales/aislamiento & purificación , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Antifúngicos/uso terapéutico , Triazoles/uso terapéutico , Mucormicosis/complicaciones , Mucorales/patogenicidad , Síndrome de Down/complicaciones , Terapia Recuperativa/métodosRESUMEN
Antecedentes: La descripción antiguamente más frecuente de la mucormicosis era la afectación nasosinusal en pacientes con cetoacidosis diabética. Sin embargo, en los últimos años han surgido nuevos grupos de pacientes con riesgo de mucormicosis. Objetivos y métodos: Se realizó un análisis retrospectivo de las características, tratamiento y evolución de los pacientes con mucormicosis en nuestro hospital (años 2012-2016). Resultados: De los 12 pacientes del estudio, siete padecían alguna enfermedad hematológica como factor predisponente, la mayoría (6 pacientes) por trasplante de progenitores hematopoyéticos. Solamente un paciente estaba en cetoacidosis diabética. Siete pacientes del total estaban recibiendo antifúngicos al inicio de los síntomas, y 9 pacientes los habían recibido los tres meses previos. La afectación fue rinosinusal (16,6%), pulmonar localizada (33,3%), musculoesquelética (25%) y diseminada (25%). En 8 pacientes se realizó desbridamiento quirúrgico. Seis pacientes recibieron tratamiento combinado con anfotericina B y posaconazol (mortalidad de grupo 16%), y 4 pacientes fueron tratados con anfotericina B en monoterapia (mortalidad 50%), con una mortalidad global del 41%. La mortalidad de los pacientes con afectación pulmonar fue del 71%, y en el caso de enfermedad diseminada del 100%. Ningún paciente con afectación únicamente musculoesquelética falleció. Conclusiones: La mucormicosis sigue teniendo una elevada mortalidad, especialmente las formas pulmonares. Las formas musculoesqueléticas tuvieron mejor pronóstico. El grupo de riesgo principal fue el de los pacientes con trasplante de médula ósea. El tratamiento combinado obtuvo mejores resultados que la monoterapia, aunque se necesita más experiencia para definir el tratamiento más adecuado
Background: The most common presentation of mucormycosis in the past was the nasosinusal involvement in patients with diabetic ketoacidosis. However, in the last few years, new groups of patients with risk of mucormycosis have emerged. Aims and methods: Retrospective analysis of the characteristics, treatment and evolution of patients with mucormycosis in a tertiary hospital in the years 2012-2016. Results: Of the 12 patients included in the study, 7 had a haematological disease as a predisposing factor, most of them (6 patients) related to transplantation of haematopoietic progenitors. Only one patient had diabetic ketoacidosis. Seven out of the twelve patients were receiving an antifungal treatment at the onset of symptoms, and 9 patients had received them three months before. The clinical presentation was rhinosinusal (16.6%), localised lung disease (33.3%), and musculoskeletal (25%) and disseminated disease (25%). Surgical debridement was performed on 8 patients. Combination therapy with amphotericin B and posaconazole was received by 6 patients (16% mortality), and 4 patients were treated with amphotericin B alone (50% mortality), with an overall mortality of 41%. The mortality of patients with pulmonary involvement was 71%, increasing to 100% in the case of disseminated disease. None of the patients with only musculoskeletal involvement died. Conclusions: Mucormycosis has a high mortality rate, especially the pulmonary forms. Musculoskeletal involvement had a better prognosis. The main group at risk was that of patients with haematopoietic stem cell transplantation. Combination therapy had better results than monotherapy, although more experience is needed to define the most appropriate treatment
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Mucormicosis/epidemiología , Mucorales/aislamiento & purificación , Enfermedades Hematológicas/complicaciones , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Mucorales/patogenicidad , Atención Terciaria de Salud/estadística & datos numéricos , Factores de Riesgo , Estudios Retrospectivos , Antifúngicos/uso terapéuticoRESUMEN
Antecedentes. La mucormicosis pulmonar es una infección oportunista rara con alta mortalidad causada por hongos Mucorales. Los más frecuentes son Rhizopus, Mucor, Lichtheimia y Rhizomucor. Caso clínico. Se presenta el caso de una mujer de 56 años con diabetes mellitus tipo 2 y enfermedad renal crónica, receptora de un trasplante de riñón cadavérico dos años antes de su ingreso. Por este motivo recibió tratamiento inmunomodulador con timoglobulina, micofenolato de mofetilo, tacrolimus y prednisona. La paciente ingresó por un cuadro neumónico con tos, expectoración y disnea; una tomografía computarizada mostró una lesión cavitada en el lóbulo superior derecho. Con la sospecha de una aspergilosis pulmonar invasiva se comenzó un tratamiento antifúngico con voriconazol, sin mejoría. Se realizó una biopsia por aspiración con aguja fina, y en el cultivo de la misma creció Rhizomucor pusillus. La identificación se confirmó por PCR. A pesar del tratamiento con anfotericina B, la paciente presentó hemoptisis masiva incoercible, que provocó su fallecimiento. Conclusiones. La mucormicosis pulmonar es una infección rara que suele ser fatal en receptores de trasplante renal con terapia antirrechazo. Los mucorales producen fenómenos trombóticos, necrosis y destrucción tisular, que provocaron en nuestra paciente una hemoptisis incoercible. Es importante un diagnóstico preciso que permita instaurar un tratamiento quirúrgico adecuado y la administración de anfotericina B (AU)
Background. Pulmonary mucormycosis is a rare opportunistic infection with high mortality that is caused by species of Mucorales. The most common species involved are Rhizopus, Mucor, Lichtheimia, and Rhizomucor. Case report. A 56 year-old woman presented with a clinical history of diabetes mellitus type 2 and chronic renal disease. She underwent a cadaveric kidney transplantation two years before her admission, for which immunomodulating therapy with thymoglobulin, tacrolimus, mofetil-microphenolate and prednisone was established. The patient suffered a pneumonic process with cough, expectoration, and dyspnoea. The computed tomography scan showed a cavitation in the right upper lobe. With all these findings an invasive broncopulmonary aspergillosis was suspected and the patient began an antifungal treatment with voriconazole without improvement. Rhizomucor pusillus was isolated from a clinical specimen obtained by fine needle aspiration, and its identification was confirmed by PCR. After this finding amphotericin B was administered, but the patient had an uncontrolled haemoptysis and died. Conclusions. Pulmonary mucormycosis is a rare infection, usually fatal in kidney transplant recipients with anti-rejection therapy. Mucorales species usually produce thrombotic phenomena, associated with necrosis and parenchymal destruction that caused a fatal uncontrolled haemoptysis in our patient. Early diagnosis is important in order to perform any surgical treatment and to administer amphotericin B (AU)
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Hemoptisis/etiología , Trasplante de Riñón , Mucormicosis/diagnóstico , Enfermedades Pulmonares Fúngicas/diagnóstico , Mucorales/aislamiento & purificación , Diabetes Mellitus Tipo 2/complicaciones , Rhizomucor/patogenicidad , Antifúngicos/uso terapéuticoRESUMEN
Abstract:The productivity of arid legumes, such as Clusterbean (Cyamopsis tetragonoloba), Cowpea (Vigna unguiculata), Moth bean (Vigna aconitifolia) and Horse gram (Macrotyloma uniflorum), may remain stagnant over decades because of their high susceptibility to root diseases. Besides, there is a limitation on the information about molecular diagnosis and intraspecific genetic variability of root pathogens in arid legumes. To contribute in this field, we assessed a total of 52 isolates from 88 root samples that were found infected with fungal pathogens in Jodhpur, Jaipur and Bikaner Districts of Rajasthan. Diseased roots samples were analyzed following standard microbiological methods for fungus extraction and purification, and for genetic studies. Irrespective of the geographical location from where the diseased samples were collected, all pathogen isolates were clustered in RAPD dendrograms as per their respective genera. Phylogram, based on multiple sequence alignment, revealed that different genera (i.e. Fusarium, Neocosmospora and Syncephalastrum), separated from each other, and species within the same genera, clustered together with their reference sequences with apreciable bootstrap values. Out of 20 representative isolates representing each cluster and all outgroups sequenced, eight were molecularly identified as Neocosmospora vasinfecta, five as Fusarium solani, two as Neocosmospora striata, two as Fusarium acutatum, one as Syncephalastrum monosporum, one as Fusarium oxysporum and one as Fusarium species. The root pathogens of the arid legumes were found neither restricted to a geographical location nor were host specific in nature. Fusarium solani wilt in cowpea and seedling rot in moth bean, F. oxysporum wilt in moth bean, F. acutatum damping off in cowpea and Clusterbean, Fusarium sp. seedling rot in Clusterbean, Neocosmospora striata root rot in cowpea and wilt in Clusterbean and Syncephalastrum monosporum root rot in Clusterbean were molecularly identified as new fungal records as pathogens causing root diseases in arid legumes. Rev. Biol. Trop. 64 (4): 1505-1518. Epub 2016 December 01.
Resumen:La producción de leguminosas resistentes a sequías como Cyamopsis tetragonoloba, Vigna unguiculata, Vigna aconitifolia y Macrotyloma uniflorum, puede permanecer inactiva durante décadas debido a su alta susceptibilidad a enfermedades en las raíces. Además, hay información limitada relacionada con el diagnóstico molecular y la variabilidad genética intraespecífica de patógenos de raíces en estas leguminosas resistentes a sequías. Para contribuir en esta área, evaluamos un total de 52 extractos de 88 raíces infectadas con patógenos fúngicos en los distritos de Jodhpur, Jaipur y Bikaner de Rajastán. Las muestras de raíces infectadas se analizaron siguiendo los métodos estándar de microbiología para extracción y purificación de hongos y para estudios genéticos. Independientemente del sitio donde se recolectaron las muestras contaminadas, todos los extractos patógenicos se agruparon en dendrogramas RAPD en cada uno de sus respectivos géneros. El filograma, basado en alineamiento de secuencias múltiples reveló que distintos géneros (Fusarium, Neocosmospora y Syncephalastrum) separados entre ellos y especies del mismo género se agrupan con sus secuencias de referencia con valores de bootstrap significativos. De cada 20 extractos representantes de cada agrupamiento y todos los grupos externos secuenciados, ocho fueron identificados molecularmente como Neocosmospora vasinfecta, dos como Fusarium acutatum, una como Syncephalastrum monosporum, una como Fusarium oxysporum y una como Fusarium. Los patógenos de estas leguminosas resistentes a sequías no están restringidos por la localidad ni por un hospedero específico. Fusarium solani que marchita el frijol de vaca y pudre la semilla de Vigna aconitifolia, F. oxysporum que marchita a Vigna aconitifolia, F. acutatum que marchita a Vigna unguiculata y Cyamopsis tetragonoloba, Fusarium sp. que pudre la semilla de Cyamopsis tetragonoloba, Neocosmospora striata que pudre la raíz de Vigna unguiculata y marchita a Cyamopsis tetragonoloba y, Syncephalastrum monosporum que pudre la raíz en Cyamopsis tetragonoloba, fueron identificados molecularmente como nuevos registros de patógenos fúngicos que causan daños en las raíces de leguminosas resistentes a sequías.
Asunto(s)
Enfermedades de las Plantas/microbiología , Técnicas de Diagnóstico Molecular/métodos , Vigna/microbiología , Fusarium/aislamiento & purificación , Hypocreales/aislamiento & purificación , Fabaceae/microbiología , Mucorales/aislamiento & purificación , Variación Genética , ADN de Hongos , Raíces de Plantas/genética , Técnica del ADN Polimorfo Amplificado Aleatorio , Polimorfismo de Nucleótido Simple , Vigna/genética , Hypocreales/genética , India , Fabaceae/genéticaRESUMEN
Las micosis invasivas causadas por hongos filamentosos afectan principalmente a pacientes que presentan alteraciones de la inmunidad. Esta revisión se centra en la patogenia de tales micosis causadas por los principales hongos filamentosos productores de infecciones fúngicas invasivas en el ser humano (mucorales y especies de Aspergillus, Fusarium y Scedosporium). Para ello se detallan procesos clave como el contacto inicial entre el huésped y el hongo, la interacción del hongo con las mucosas, la activación del sistema inmune innato y adaptativo, el papel de los receptores más importantes de la respuesta inmune, los factores genéticos del huésped y otros como los determinantes de virulencia de las diferentes especies fúngicas (AU)
Invasive fungal infections caused by filamentous fungi are devastating diseases that occur in patients with a variety of immunosuppressive conditions. This review focuses on the pathogenesis of the most important invasive mycosis in the human being caused by the filamentous fungi Aspergillus, Fusarium, Scedosporium and mucorales. The first contact between the mould and the patient, the host defense to different fungi, including the role of mucosa in the innate immune system, the whole innate immune recognition receptors, and the pathways connecting innate and adaptive immunity, as well as the virulence factors of fungi, are discussed in this paper (AU)
Asunto(s)
Humanos , Masculino , Femenino , Micosis/diagnóstico , Micosis/microbiología , Hongos , Hongos/aislamiento & purificación , Aspergillus , Aspergillus/aislamiento & purificación , Terapia de Inmunosupresión/métodos , Corticoesteroides/uso terapéutico , Mucorales , Mucorales/aislamiento & purificación , Fusarium , Fusarium/aislamiento & purificación , Scedosporium , Scedosporium/aislamiento & purificaciónRESUMEN
Las infecciones invasivas por mohos, fundamentalmente por Aspergillus, suponen más del 10% de las complicaciones infecciosas en el trasplante pulmonar. Suelen tener una presentación bimodal: precoces, principalmente invadiendo la vía aérea, y tardías, más frecuentemente localizadas en pulmón o diseminadas. La colonización en cualquier momento postrasplante es uno de los principales factores de riesgo. Dicha colonización es, junto con el rechazo crónico, una de las principales causas de las formas tardías. Un valor de 0,5 de galactomanano en el lavado broncoalveolar se considera actualmente indicativo de infección invasiva. No hay una estrategia universal de actuación en materia de profilaxis. La profilaxis dirigida y el tratamiento anticipado van teniendo más adeptos, en contraposición a la profilaxis universal. La monitorización de las concentraciones de los azoles en los enfermos se considera altamente indicada durante el tratamiento. La monoterapia con voriconazol es el tratamiento de elección en la aspergilosis, y solo se recomiendan terapias combinadas ante aspergilosis graves, diseminadas y por otros mohos (AU)
Invasive infections by molds, mainly Aspergillus infections, account for more than 10% of infectious complications in lung transplant recipients. These infections have a bimodal presentation: an early one, mainly invading bronchial airways, and a late one, mostly focused on lung or disseminated. The Aspergillus colonization at any time in the post-transplant period is one of the major risk factors. Late colonization, together with chronic rejection, is one of the main causes of late invasive forms. A galactomannan value of 0.5 in bronchoalveolar lavage is currently considered a predictive factor of pulmonary invasive infection. There is no universal strategy in terms of prophylaxis. Targeted prophylaxis and preemptive treatment instead of universal prophylaxis, are gaining more followers. The therapeutic drug monitoring level of azoles is highly recommended in the treatment. Monotherapy with voriconazole is the treatment of choice in invasive aspergillosis; combined antifungal therapies are only recommended in severe, disseminated, and other infections due to non-Aspergillus molds (AU)
Asunto(s)
Humanos , Masculino , Femenino , Hongos/aislamiento & purificación , Aspergillus/aislamiento & purificación , Trasplante de Pulmón/efectos adversos , Trasplante de Pulmón/métodos , Rechazo de Injerto/complicaciones , Rechazo de Injerto/diagnóstico , Factores de Riesgo , Aspergilosis Pulmonar Invasiva/complicaciones , Aspergilosis Pulmonar Invasiva/diagnóstico , Infecciones/complicaciones , Infecciones/diagnóstico , Lavado Broncoalveolar/efectos adversos , Azoles/uso terapéutico , Scedosporium/aislamiento & purificación , Mucorales/aislamiento & purificación , Profilaxis AntibióticaRESUMEN
Nineteen taxa of Mucorales, belonging to Absidi, Apophysomyces, Cunninghamella, Fennellomyces, Lichtheimi, Mucor, Mycotypha, Rhizopus and Syncephalastrum were isolated from 36 composite soil samples in three semiarid areas in the State of Pernambuco (Triunfo, Cabrobó and Belém de São Francisco), Northeast Brazil, which are characterized by Caatinga vegetation. Triunfo is preserved, whereas Cabroró and Belém de São Francisco are experiencing low and severe desertification processes, respectively. Mucorales were isolated in Petri dishes in triplicate from 5 mg samples of soil placed on the surface of wheat germ agar plus chloramphenicol and Cercobin [Dimethyl 4,49-(103 phenylene) bis (3-thioallophanate)] medium. The plates were left on a bench at room temperature (28 ± 2 ºC) for 72 h of alternating dark and light periods. Absidia cylindrospora presented the highest amount of CFU/g of soil, followed by L. hyalospor, C. phaeospora and C. echinulata var. echinulata. The latter, and R. microsporus var. microsporus, presented the highest frequencies of occurrence. Soils from Triunfo showed higher diversity of Mucorales than the samples from the other areas, although without differing statistically in relation to species richness. The communities of Mucorales from the degraded areas were more similar, while that from the preserved area was quite different. Most of the identified specimens have been commonly isolated from soil in other Brazilian regions, which indicates that they are not endemic of the semiarid. Eleven taxa are registered for the first time in this ecosystem, while F. heterothallicus is reported for the first time in Brazil.
Asunto(s)
Zona Árida , Biodiversidad , Clasificación , Ecosistema , Microbiología Ambiental , Mucorales/aislamiento & purificación , Biodegradación Ambiental , Hongos , Métodos , SueloRESUMEN
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Asunto(s)
Humanos , Femenino , Anciano , Mucormicosis/diagnóstico , Mucormicosis/tratamiento farmacológico , Mucormicosis/cirugía , Úlcera Cutánea/diagnóstico , Úlcera Cutánea/tratamiento farmacológico , Úlcera Cutánea/cirugía , Anfotericina B/uso terapéutico , Vasos Sanguíneos , Vasos Sanguíneos/patología , Mucorales , Mucorales/aislamiento & purificaciónRESUMEN
Mucoraleswere isolated from maize flour, corn meal and cooked cornflakes using surface and depth plate methods. Rhizopus oryzae, Circinella muscae, Mucor subtilissimus,Mucor hiemalis f. hiemalis, Syncephalastrum racemosum, Rhizopus microsporus var. chinensis and Absidia cylindrospora showed protease activity.
Mucorales foram isolados da farinha de milho, fubá e flocos de milho pré-cozidos pelos métodos de plaqueamento em superfície e em profundidade. Rhizopus oryzae, Circinella muscae, Mucor subtilissimus,Mucor hiemalis f. hiemalis, Syncephalastrum racemosum, Rhizopus microsporus var. chinensis e Absidia cylindrospora exibiram atividade proteásica.
Asunto(s)
Contaminación de Alimentos , Hongos/aislamiento & purificación , Mucorales/aislamiento & purificación , Péptido Hidrolasas/aislamiento & purificación , Zea mays , Muestras de Alimentos , Alimentos Industrializados , Métodos , MétodosRESUMEN
La mucormicosis es una infección oportunista, producida por los hongos del orden mucorales. Tiene una baja incidencia. Es potencialmente letal y afecta a pacientes inmunocomprometidos. Presentamos 7 casos de mucormicosis rinocerebral en un estudio retrospectivo de 8 años (20002008) en pacientes hematológicos. Es preciso realizar un diagnóstico precoz, para lo cual se ha de mantener un alto índice de sospecha clínica en pacientes con factores predisponentes. El diagnóstico de certeza requiere la realización de cultivos o biopsias de las zonas afectadas que demuestren la invasión de los tejidos por las hifas características. La clave del tratamiento es el desbridamiento quirúrgico precoz y agresivo, junto con altas dosis de amfotericina B intravenosa. A pesar de este tratamiento, el pronóstico es desfavorable y la mortalidad es de un 7080% (AU)
Mucormycosis is an opportunistic fungal infection caused by fungi of the Mucorales order. It has a low incidence and is a potentially lethal infection which generally affects patients who are immunocompromised due to systemic disease. We report 7 cases of rhinocerebral mucormycosis in a retrospective study of 8 years (20002008) in hematologyc patients. An early diagnosis is essential, and therefore there must be a high level of clinical suspicion in patients with predisposing factors. Certainty diagnosis requires fungal cultures or biopsies of the affected areas which prove an invasion of the tissues by the characteristic hyphae. The key to treatment is early and aggressive surgical treatment, together with high intravenous doses of B amphotericyn. Despite this, prognosis is poor and mortality is about 7080% (AU)