Fusarium solani hyalohyphomycosisin loggerhead sea turtles (Caretta caretta): a diagnostic and therapeutical challenge.

Fusarium spp. are pathogens plants, animals and humans, isolated from soil, plants and water systems. They are distributed worldwide and include saprotrophic, biotrophic­pathogenic or endophytic fungi, or producers of mycotoxins (fumonisins). Human isolates are becoming the leading mycosis affecting immunocompromised patients and frequently involved in mycoses of aquatic mammals and reptiles, included sea turtles or their eggs. Here reported are three severe cases of unusual localizations of Fusarium in loggerhead sea turtle (Caretta caretta) and their diagnostic, therapeutic and clinical output. In the clinical practice, correct genus­level identification of Fusarium species is critically important to enable correct treatment as in vitroantifungal susceptibility testing is mandatory for each Fusarium­like isolate. For this reason, susceptibility testing can significantly help the practitioner in choosing the most appropriate therapeutic protocol.

Subcutaneous hyalohyphomycosis caused by Fusarium in a kidney transplant recipient.

Fusarium is a filamentous opportunistic pathogenic fungus responsible for superficial as well as invasive infection in immunocompromized hosts. Net state of immunosuppression and cytomegalovirus (CMV) infection appear to predispose to this disease which is life-threatening when disseminated. Though infections with Fusarium have been widely described in hematological malignancies and hematopoietic stem cell transplant cases, they have been reported to be rare in solid organ transplant recipients, are often localized and carry a favorable prognosis. We here describe a rare case of subcutaneous non-invasive infection with Fusarium in a renal allograft recipient two and half years after transplantation. Patient had a previous history of CMV infection along with multiple other recurrent co-infections. Diagnosis was based on culture of tissue specimens yielding Fusarium species. The infection had a protracted course with persistence of lesions after treatment with voriconazole alone, requiring a combination of complete surgical excision and therapy with the anti-fungal drug.

Rare opportunistic mycoses in cats: phaeohyphomycosis and hyalohyphomycosis: ABCD guidelines on prevention and management.

OVERVIEW: Phaeohyphomycoses and hyalohyphomycoses are rare opportunistic infections acquired from the environment. More cases have been reported in recent years in humans and cats. DISEASE SIGNS: Single or multiple nodules or ulcerated plaques (which may be pigmented) in the skin are the typical lesions. In some cases the infection disseminates or involves the central nervous system (CNS). DIAGNOSIS: Diagnosis is based on fungal detection by cytology and/or histology. Culture provides definitive diagnosis and species identification. TREATMENT: Treatment involves surgical excision in cases of localised skin disease followed by systemic antifungal therapy, with itraconazole as the agent of first choice. Relapses after treatment are common. Itraconazole and other systemic antifungal agents have been used to treat systemic or neurological cases, but the response is unpredictable. The prognosis is guarded to poor in cats with multiple lesions and systemic or neurological involvement. ZOONOTIC RISK: There is no zoonotic risk associated with contact with infected cats.