RESUMEN
Eumycetoma caused by Madurella fahalii, a drug-resistant fungus, has never been reported in India. Here, we describe a fatal case of eumycetoma with spinal involvement due to M. fahalii for the first time in India.
Asunto(s)
Madurella , Micetoma , Humanos , India , Micetoma/microbiología , Micetoma/diagnóstico , Micetoma/tratamiento farmacológico , Madurella/aislamiento & purificación , Masculino , Resultado Fatal , Columna Vertebral/microbiología , Columna Vertebral/patología , Columna Vertebral/diagnóstico por imagen , Antifúngicos/uso terapéuticoRESUMEN
The world is heading towards an era of intractable and impending untreatable N. gonorrhoeae, thereby underlining the significance of rapid and accurate prediction of drug resistance as an indispensable need of the hour. In the present study, we optimized and evaluated a stable isotope labeling-based approach using the MALDI-TOF MS (Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry) for rapid and reliable detection of ciprofloxacin and azithromycin resistance in N. gonorrhoeae. All the isolates were cultured under three varied condition setups viz. medium supplemented with normal lysine, heavy lysine (isotope), and heavy lysine along with the antibiotics (ciprofloxacin/azithromycin), respectively. After incubation, spectra were acquired using the MALDI-TOF MS which were further screened for unique patterns (media-specific spectra) to differentiate drug-susceptible and resistant isolates. The results of the stable isotope labeling assay were comparable to the results of phenotypic methods used for susceptibility testing.
Asunto(s)
Mycobacterium tuberculosis , Neisseria gonorrhoeae , Azitromicina , Marcaje Isotópico , Lisina , Pruebas de Sensibilidad Microbiana , Antibacterianos/farmacología , Ciprofloxacina/farmacología , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción/métodos , Medios de Cultivo CondicionadosAsunto(s)
Dermoscopía/métodos , Esporotricosis/diagnóstico , Adulto , Humanos , Masculino , Esporotricosis/patologíaRESUMEN
While neurological manifestations in scrub typhus have been well described both in clinical and radiological reports in the literature, neuropathological features are rarely reported. They range from subtle "typhus nodules" to more widespread capillaritis. Familiarity with pathological features is essential for correct interpretation. We describe the clinical, imaging, and histological findings in an autopsy case of scrub typhus, which was pre-terminally superimposed by fungal meningoencephalitis. Interestingly, the autopsy revealed morphological evidence of both etiologies.
Asunto(s)
Encéfalo/patología , Enfermedades del Sistema Nervioso Central/etiología , Enfermedades del Sistema Nervioso Central/patología , Tifus por Ácaros/complicaciones , Autopsia/métodos , Encéfalo/metabolismo , Enfermedades del Sistema Nervioso Central/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tifus por Ácaros/diagnóstico por imagenAsunto(s)
Mucormicosis , Necrosis , Síndrome de Stevens-Johnson , Antifúngicos/uso terapéutico , Antimaníacos/efectos adversos , Antimaníacos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Carbamazepina/efectos adversos , Carbamazepina/uso terapéutico , Resultado Fatal , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Masculino , Persona de Mediana Edad , Mucorales , Mucormicosis/complicaciones , Mucormicosis/diagnóstico , Mucormicosis/tratamiento farmacológico , Mucormicosis/microbiología , Necrosis/complicaciones , Necrosis/diagnóstico , Necrosis/tratamiento farmacológico , Necrosis/etiología , Piel/patología , Síndrome de Stevens-Johnson/complicaciones , Síndrome de Stevens-Johnson/diagnóstico , Síndrome de Stevens-Johnson/tratamiento farmacológico , Síndrome de Stevens-Johnson/etiologíaRESUMEN
Aspergillus tracheobronchitis is an extremely uncommon manifestation of Aspergillus infection. Most of the cases described in the literature are in the immunosuppressed individuals and is almost uniformly fatal. Immunocompetent individuals do manifest the disease, but the disease if diagnosed early can be appropriately treated and thus can be life-saving. Here, we describe a similar case which was diagnosed only at autopsy.
RESUMEN
Cryptococcosis is a fungal infection that usually occurs in immunocompromised individuals. Meningitis is the most frequent presentation; uncommonly, a disseminated form occurs. Cryptococcosis can sometimes occur in immunocompetent individuals with certain predisposing conditions such as diabetes mellitus. However, disseminated cryptococcosis is exceedingly rare in these individuals. A 48-year-old man presented with a lung mass and was initially suspected to have bronchogenic carcinoma. However, on further evaluation, it turned out to be disseminated cryptococcosis due to Cryptococcus gattii, with pulmonary, pleural and meningeal involvement.
Asunto(s)
Criptococosis/diagnóstico , Criptococosis/metabolismo , Diabetes Mellitus/microbiología , Enfermedades Pulmonares/microbiología , Cryptococcus gattii/aislamiento & purificación , Diabetes Mellitus/metabolismo , Diagnóstico Diferencial , Femenino , Humanos , Huésped Inmunocomprometido , Enfermedades Pulmonares/metabolismo , Masculino , Persona de Mediana EdadRESUMEN
Onychomycosis is a common chronic nail disorder where dermatophytes are the predominant pathogens. However, non-dermatophytic moulds like Aspergillus can also be implicated as the causative agents. Herein, we report a rare case of onychomycosis due to Emericella quadrilineata ( Aspergillus tetrazonus) in an apparently immunocompetent host.
Asunto(s)
Emericella/clasificación , Emericella/aislamiento & purificación , Onicomicosis/diagnóstico , Onicomicosis/patología , Emericella/citología , Humanos , Masculino , Técnicas Microbiológicas , Microscopía , Persona de Mediana Edad , Onicomicosis/microbiologíaAsunto(s)
Diabetes Mellitus Tipo 1/complicaciones , Mucormicosis/microbiología , Rinitis/microbiología , Sinusitis/microbiología , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Niño , Preescolar , Desbridamiento , Ácido Desoxicólico/uso terapéutico , Combinación de Medicamentos , Humanos , Mucormicosis/terapia , Rinitis/terapia , Sinusitis/terapiaRESUMEN
We report a rare case of phaeohyphomycotic cyst in an immunocompetent patient caused by Exophiala oligosperma. This fungus is earlier known to cause infections in the immunocompromised. Identification of black fungi at species level is more challenging by conventional methods, and hence final identification of the fungi was based on sequencing of rDNA. The patient was managed with surgical excision. To the best of our knowledge, this is the first case report of E. oligosperma human infection from India.
Asunto(s)
Quistes/etiología , Quistes/patología , Exophiala/aislamiento & purificación , Feohifomicosis/diagnóstico , Feohifomicosis/patología , Adulto , Quistes/microbiología , Quistes/cirugía , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Desbridamiento , Exophiala/clasificación , Exophiala/genética , Humanos , India , Masculino , Microscopía , Datos de Secuencia Molecular , Feohifomicosis/microbiología , Feohifomicosis/cirugía , Análisis de Secuencia de ADNRESUMEN
Mucormycosis is an uncommon systemic mycosis affecting the immunocompromised individuals. It is usually caused by organisms of the genera Rhizopus and Mucor, although rarely other organisms have also been implicated. Mycoses due to these angioinvasive fungi have an acute onset, rapidly progressive course with high mortality rate. A rare and less well known is the chronic subtype of primary cutaneous mucormycosis (PCM). Herein, we report a case of PCM clinically presenting as a chronic, giant destructive plaque in a young immunocompetent male and coin the term chronic granulomatous mucormycosis. A clinicopathological classification for cutaneous mucormycosis is also proposed.
Asunto(s)
Dermatomicosis/diagnóstico , Dermatomicosis/patología , Mucor/aislamiento & purificación , Mucormicosis/diagnóstico , Mucormicosis/patología , ADN de Hongos/química , ADN de Hongos/genética , ADN Espaciador Ribosómico/química , ADN Espaciador Ribosómico/genética , Dermatomicosis/microbiología , Histocitoquímica , Humanos , Masculino , Microscopía , Datos de Secuencia Molecular , Mucor/clasificación , Mucor/genética , Mucormicosis/microbiología , Análisis de Secuencia de ADN , Piel/patología , Adulto JovenRESUMEN
Cutaneous aspergillosis is a common systemic mycosis affecting immunosuppressed patients. Here, we describe a novel morphological type of cutaneous aspergillosis in a young immunocompetent woman who presented with a chronic history of multiple nodules and discharging sinuses over left side of the face, mimicking cervicofacial actinomycosis. Skin biopsy showed granulomatous inflammation, and of septate fungal hyphae with acute-angled branching, morphologically resembling Aspergillus. This was confirmed on fungal culture as Aspergillus flavus.
Asunto(s)
Aspergilosis/diagnóstico , Aspergilosis/microbiología , Aspergillus flavus/aislamiento & purificación , Granuloma/microbiología , Enfermedades de los Senos Paranasales/microbiología , Senos Paranasales/microbiología , Actinomicosis/diagnóstico , Actinomicosis/microbiología , Adulto , Aspergillus flavus/genética , Femenino , Granuloma/diagnóstico , Humanos , Enfermedades de los Senos Paranasales/diagnósticoRESUMEN
We describe a possible imported case of osteo-articular coccidioidomycosis in India. Culture of the computed tomography-guided aspirate revealed the growth of Coccidioides spp., which was identified as Coccidioides posadasii by sequencing of the internal transcribed spacer (ITS) region of rDNA. He was successfully treated with amphotericin B followed by itraconazole. All the previous published reports of coccidioidomycosis cases diagnosed in India are also reviewed in order to increase the awareness of this disease in non-endemic areas.
Asunto(s)
Coccidioides/genética , Coccidioides/aislamiento & purificación , Coccidioidomicosis/diagnóstico , Adulto , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Biopsia con Aguja Fina , Coccidioides/clasificación , Coccidioidomicosis/tratamiento farmacológico , Coccidioidomicosis/microbiología , Diagnóstico Diferencial , Humanos , India , Itraconazol/uso terapéutico , Masculino , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , TuberculosisRESUMEN
We present a case of cutaneous hyalohyphomycosis due to Acremonium strictum in an immunocompetent individual along with an overview of fungal infections caused by A. strictum. The diagnosis was confirmed by the presence of hyphae in microscopic examination of cutaneous biopsy and discharge, positive culture for A. strictum and sequencing of the isolate at reference centre. The infection resolved with itraconazole and terbinafine. Cutaneous or subcutaneous infections of A. strictum have rarely been reported. Fungemia or disseminated infection often with fatal outcome in immunocompromised patients was the most common presentation of A. strictum infection found in the literatures. The studies also reveal worldwide variation in the treatment regime and outcome of the treatment.
RESUMEN
Rhizomucor variabilis is a rare cause of human infections. We report a case of primary cutaneous zygomycosis in an immunocompetent host. Although microscopy reveals the fungal aetiology, the need for species identification is highlighted to better understand the species and establish an epidemiological pattern as it is reported from restricted geographical locations.
Asunto(s)
Dermatomicosis/diagnóstico , Dermatomicosis/patología , Rhizomucor/aislamiento & purificación , Cigomicosis/diagnóstico , Cigomicosis/patología , ADN de Hongos/química , ADN de Hongos/genética , ADN Espaciador Ribosómico/química , ADN Espaciador Ribosómico/genética , Dermatomicosis/microbiología , Humanos , Masculino , Persona de Mediana Edad , Análisis de Secuencia de ADN , Cigomicosis/microbiologíaRESUMEN
A 55-year-old female patient with malignant lymphoma after induction chemotherapy developed fever. Blood culture yielded an organism biochemically identified as representing Nocardia spp., but molecular identification (16S rRNA gene sequencing) later identified it as representing Sciscionella marina. This is the first report, to the best of our knowledge, of Sciscionella being isolated from a human sample.
Asunto(s)
Infecciones por Actinomycetales/microbiología , Actinomycetales/clasificación , Actinomycetales/aislamiento & purificación , Bacteriemia/microbiología , Linfoma/complicaciones , Actinomycetales/genética , Infecciones por Actinomycetales/diagnóstico , Técnicas de Tipificación Bacteriana , Femenino , Humanos , Persona de Mediana Edad , Datos de Secuencia Molecular , Nocardia/clasificación , Nocardia/genética , Nocardia/aislamiento & purificación , Fenotipo , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADNRESUMEN
Diagnostic efficacy of Galactomannan (GM) assay for invasive aspergillosis (IA) is variably reported. Data from developing countries are scant. Children with haematological malignancies and fever were enrolled prospectively. Blood sample for GM was drawn on the day of admission; levels were measured with Platellia Aspergillus enzyme immunoassay. Diagnostic criteria were adapted from EORTC-MSG-2002. Proven, probable and possible episodes were considered as the disease group. One hundred febrile episodes in 78 patients were evaluated. The mean age was 6.1 years. Majority (75%) episodes were in patients with acute lymphoblastic leukaemia. One episode each was diagnosed with proven and probable IA, while 23 were diagnosed with possible IA. Best results were obtained with a cut-off value of 1.0, with sensitivity, specificity, positive and negative predictive value of 60%, 93%, 75 and 87 respectively. The sensitivity dropped to 40%, at cut-off value of 1.5 and specificity was 38%, at a cut-off of 0.5. A higher value of GM correlated with pulmonary nodules (P = 0.037) and mortality (P = 0.001). GM assay is adjunctive to clinical/radiological evidence. A negative GM assay may not reassure the physician against the use of amphotericin in patients with febrile neutropenia, as it does not exclude the diagnosis of clinically relevant other fungal infections, particular mucormycosis.
Asunto(s)
Fungemia/diagnóstico , Neoplasias Hematológicas/complicaciones , Aspergilosis Pulmonar Invasiva/diagnóstico , Mananos/sangre , Adolescente , Niño , Preescolar , Femenino , Galactosa/análogos & derivados , Humanos , Lactante , Masculino , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Suero/químicaAsunto(s)
Válvula Aórtica/microbiología , Endocarditis/microbiología , Exophiala/aislamiento & purificación , Antifúngicos/uso terapéutico , Válvula Aórtica/cirugía , Dolor en el Pecho/microbiología , Dolor en el Pecho/patología , ADN de Hongos/genética , Exophiala/genética , Femenino , Fiebre/microbiología , Humanos , Trasplante de Riñón , Persona de Mediana Edad , Feohifomicosis/tratamiento farmacológico , Feohifomicosis/microbiología , Pirimidinas/uso terapéutico , Triazoles/uso terapéutico , VoriconazolRESUMEN
Exophiala spinifera is a rare fungus causing chromoblastomycosis or different types of phaeohyphomycosis (cutaneous, subcutaneous, disseminated and cyst phaeohyphomycosis). We report a case of a young male with phaeohyphomycosis due to E. spinifera, who had multiple itchy painful papular lesions disfiguring his face for 4 years. His diagnosis was delayed and had received antibacterial and antileishmanial therapy elsewhere without any improvement. While he reported to our hospital, the histopathology of the biopsy collected from the lesion demonstrated acute on chronic inflammation with granuloma formation and darkly pigmented fungal elements. The isolate grown on culture was identified as E. spinifera on the basis of morphological characters. The identification of the isolate was further confirmed by sequencing of the ITS region of ribosomal DNA. After treatment with oral itraconazole, he had marked clinical improvement.
Asunto(s)
Cromoblastomicosis/microbiología , Exophiala/aislamiento & purificación , Cara/microbiología , Adulto , Antifúngicos/uso terapéutico , Cromoblastomicosis/tratamiento farmacológico , Cromoblastomicosis/inmunología , Cromoblastomicosis/patología , Exophiala/efectos de los fármacos , Exophiala/genética , Cara/patología , Humanos , Huésped Inmunocomprometido , MasculinoRESUMEN
In this report, we present a case of rhino-orbital mucormycosis in a 57-year-old female with poorly controlled diabetes mellitus. The only mold cultured at 25°C, 37°C, and 40°C from a specimen of the nasal crust was identified phenotypically and independently using nuclear ribosomal DNA sequence data as Thamnostylum lucknowense. To our knowledge, this report presents the first data implicating this mucoraceous fungus as a mycotic agent of human infection.