Necrotising pneumonia caused by Curvularia hawaiiensis (syn. Bipolaris hawaiiensis) and Mycobacterium tuberculosis coinfection in a patient with ascariasis: a case report and review.

INTRODUCTION: Curvularia hawaiiensis (formerly Bipolaris hawaiiensis) is a plant pathogen often isolated from soil and vegetative material. However, only a few cases of opportunistic invasive infections in humans have been described. CASE: A 16-year-old female patient without comorbidities was admitted to the emergency department because of fever and chest pain. We described the first coinfection of Curvularia hawaiiensis and Mycobacterium tuberculosis necrotising pneumonia. DISCUSSION: Multiple infections can alter immune responses. However, immunosuppression is the most critical risk factor for infection with species of the genus Curvularia. Therefore, it is crucial to carefully examine patients with tuberculosis, as they may rarely be coinfected with unusual fungi.

An old confusion: Entomophthoromycosis versus mucormycosis and their main differences.

Fungal diseases were underestimated for many years. And the global burden of fungal infections is substantial and has increased in recent years. Invasive fungal infections have been linked to several risk factors in humans which basically depend on the individual homeostasis of the patients. However, many fungi can infect even apparently healthy people. Knowledge of these pathogens is critical in reducing or stopping morbidity and/or mortality statistics due to fungal pathogens. Successful therapeutic strategies rely on rapid diagnosis of the causative fungal agent and the underlying disease. However, the terminology of the diseases was updated to existing phylogenetic classifications and led to confusion in the definition of mucormycosis, conidiobolomycosis, and basidiobolomycosis, which were previously grouped under the now-uncommon term zygomycosis. Therefore, the ecological, taxonomic, clinical, and diagnostic differences are addressed to optimize the understanding and definition of these diseases. The term "coenocytic hyphomycosis" is proposed to summarize all fungal infections caused by Mucorales and species of Basidiobolus and Conidiobolus.

Mini Review: Risk Assessment, Clinical Manifestation, Prediction, and Prognosis of Mucormycosis: Implications for Pathogen- and Human-Derived Biomarkers.

Mucormycosis is a fungal disease caused by members of the fungal order Mucorales, which are abundantly found in terrestrial environments. The fungi propagate clonally via mitospores, which are transmitted to humans through the air and cause superficial or invasive infections. The disease has emerged in recent years and coincides generally with immunosuppression on the patient side. Mucormycosis is still rarely recognized in the clinical because of its unspecific symptoms which often triggers misdiagnosis with bacterial or viral infections leading to prolonged therapeutic cycles and loss of valuable time to manage mucormycosis properly. Infected patients develop various clinical forms, most notably ranging from rhinocerebral via pulmonary to gastrointestinal forms. Traditional diagnosis is based on culture and histopathologic examinations of the affected tissue. But, the achievement of a precise result is time-consuming, labor-intensive, requires mycological expertise and the finding appears often too late. A rapid and precise diagnosis is mandatory because symptoms are non-specific and the disease is rapidly progressing with often fatal outcome. Mucormycosis was increasingly associated with other infections and underlying conditions and risk factors causing comorbidities, which are difficult to successfully manage. This mini-review summarizes the current knowledge on the epidemiology and causative agents of mucormycosis, transmission, risk factors, clinical presentation, diagnosis, and highlights the lack of appropriate biomarkers on the pathogen and the host sides for rapid pathogen and host susceptibility detection, respectively. Fungal antigens and single nucleotide polymorphisms (SNPs) in human host genes are useful for the assessment of susceptibility. This mini-review addresses possibilities for early prediction of susceptibility to mucormycosis based on forecasting of the risk of infection with fungal pathogens other than Mucorales. The topic of early prediction and diagnosis of mucormycosis represents a current research gap and highlights the importance of potential future developments in the area of risk assessment, susceptibility prognosis in conjunction with early diagnosis to reduce mortality in patients suffering from mucormycosis.

Mycetoma caused by Phellinus species: a rare case from Brazil / Micetoma causado por especies de phellinus: un caso raro de Brasil

Abstract Mycetoma is a chronic and slow-developing granulomatous disease characterized by the triad of large painless tumour-like subcutaneous swellings, the formation of sinuses, and discharge that usually contains grains. Phellinus spp. are saprophytic wood-decaying filamentous basidiomycetes. They are an under-recognised cause of invasive fungal infections and are rarely reported worldwide. We report a 59-year-old male patient with mycetoma caused by Phellinus spp. The diagnosis was confirmed with clinical examination, magnetic resonance imaging (MRI) study, soft tissue and bone biopsy culture, and polymerase chain reaction. To the best of our knowledge, this is the first reported case of mycetoma due to Phellinus spp. without chronic granulomatous disease (CGD).

Resumen El micetoma es una enfermedad granulomatosa crónica y de lento desarrollo caracterizada por la tríada de grandes inflamaciones subcutáneas similares a tumores indoloras, la formación de los senos nasales y secreción que generalmente contiene granos. Phellinus spp. son basidiomicetos filamentosos saprofitos que descomponen la madera. Son un poco reconocido causa de infecciones fúngicas invasivas y rara vez se informan en todo el mundo. Presentamos un paciente masculino de 59 años con micetoma causado por Phellinus spp. El diagnostico se confirmó con examen clínico, estudio de resonancia magnética (RM), cultivo de biopsia de tejido blando y óseo y reacción en cadena de la polimerasa. A lo mejor que sepamos, este es el primer caso reportado de micetoma debido a Phellinus spp. sin enfermedad granulomatosa crónica (EGC).

Variante de SARS-CoV-2 VUI 202012/01 (B-1-1-7) en paciente pediátrico, primer reporte de caso en Ecuador / SARS-CoV-2 variant VUI 202012/01 (B-1-1-7) in pediatric patient, first case report in Ecuador

Introducción: Los virus de RNA son conocidos por tener altas tasas de variabilidad genética. El SARS-CoV-2 ha producido diversas variantes en la actualidad que pueden cambiar la presentación clínica. Se presenta el primer caso clínico de la variante B.1.1.7 con estado clínico crítico en un paciente pediátrico y nos alerta sobre la vigilancia de nuevas variantes y la relación de casos críticos en pacientes pediátricos. Caso clínico: Paciente pediátrica con antecedente de parálisis cerebral infantil, atrofia subcortical severa completa, síndrome de Lennox-Gastaut y neumonía recurrente. Presentó una evolución tórpida con necesidad de terapia intensiva por SDRA en relación con la variante B 1.1.7 del SARS-CoV-2. Evolución: Inicialmente fue atendido en un hospital privado, en el cual debido al SDRA necesitó de cuidados intensivos, fue trasladado a un hospital público en el cual posterior a 38 días fue dada de alta por evolución favorable de su cuadro infeccioso. Conclusión: Las nuevas variantes de SARS-CoV-2 pueden mostrar nuevos comportamientos clínicos. A pesar de los antecedentes del paciente estudiado, no se había observado previamente una evolución clínica hacia síntomas graves en pacientes pediátricos con COVID-19. Eso podría estar relacionado con la infección por SARS-CoV-2 variante B.1.1.7 que presentó este paciente.

Introduction: RNA viruses are known to have a high genetic variability. To date, SARS-CoV-2 has produced several variants that can change the clinical presentation of COVID-19. The first clinical case of variant B.1.1.7 with a critical clinical status in a pediatric patient is presented. It indicates that surveillance of new variants and their relationship to critical cases in pediatric patients are required. Clinical case: A pediatric patient with a history of infantile cerebral palsy, complete severe subcortical atrophy, Lennox−Gastaut syndrome, and recurrent pneumonia. She had a slow evolution requiring intensive therapy for acute respiratory distress syndrome (ARDS) that was related to SARS-CoV-2 variant B 1.1.7. Evolution: Initially, she was treated at a private hospital because she required intensive care due to ARDS, and she was then transferred to a public hospital. She was discharged after 35 days due to a favorable evolution of her infectious etiology. Conclusions: New SARS-CoV-2 variants may show new clinical behaviors. Despite this patient's history, a clinical course towards severe symptoms had not been previously observed in pediatric patients with COVID-19. The severe symptoms could be related to the SARS-CoV-2 variant B.1.1.7 infection in this patient.