RÉSUMÉ
A previously healthy 15-year-old boy from a rural county in the southeastern United States was evaluated in the emergency department with fever and worsening toe pain in the absence of trauma. He initially presented to his primary care physician 4 weeks before with upper respiratory symptoms and was treated with corticosteroids for presumed reactive airway disease. His respiratory symptoms resolved. One week after this presentation, he developed fever and right great toe pain and presented to an outside hospital. Inflammatory markers were elevated. MRI confirmed a diagnosis of osteomyelitis with associated periosteal abscess. He was treated with intravenous antibiotics and drainage of the abscess. Ten days after his discharge from the outside hospital, he developed fever and had increasing drainage of the toe and pain refractory to oral pain medications. He presented to our facility for further evaluation. Repeat MRI and inflammatory markers corroborated his worsening disease, and he was admitted to the hospital for intravenous antibiotics and underwent serial surgical debridement. He developed painful subcutaneous nodules on his lower extremities and was found to have lung abnormalities on chest radiograph. A multispecialty team collaborated in the management of this patient and unveiled a surprising diagnosis.
Sujet(s)
Abcès/microbiologie , Blastomycose/diagnostic , Fièvre/microbiologie , Hallux , Ostéomyélite/microbiologie , Douleur rebelle/étiologie , Maladies des agriculteurs/microbiologie , Amputation chirurgicale , Antibactériens/usage thérapeutique , Antifongiques/usage thérapeutique , Blastomyces/isolement et purification , Blastomycose/complications , Daptomycine/usage thérapeutique , Évolution de la maladie , Hallux/chirurgie , Humains , Itraconazole/usage thérapeutique , MâleRÉSUMÉ
A cross-sectional study on five organized pig farms was conducted to assess the faecal carriage of ESBL and blaNDM carbapenemase-producing E. coli in piglets and pig farmworkers. Faecal samples from piglets (n = 155) and pig farmworkers (n = 21) were processed for isolation and characterization of E. coli. A total of 124 E. coli isolates from piglets and 21 E. coli isolates pig farmworkers were recovered and screening for ESBL production showed that 44.4 % (55/124) of the isolates from piglets and 42.9 % (9/21) of the isolates from farmworkers were ESBL positive. The ESBL positive isolates from piglets and farmworkers harbored blaCTX-M and also co-harbored other beta-lactams, sulphonamide, quinolone and tetracycline resistance genes. Diarrhoeic (50%, 49/98) and crossbred piglets (52.7%, 39/74) harbored a significantly higher number of ESBL producing isolates than non-diarrhoeic (23.1 %, 6/26) and purebred piglets (32%, 16/50) (p < 0.05). Piglets and pig farmworkers harbored nine and two carbapenem-resistant isolates, respectively. Interestingly, two isolates from piglets and one isolate from farmworkers harbored the blaNDM gene. The blaNDM positive E. coli isolated from piglets and farmworkers of the same farm revealed similar antibacterial resistance patterns, resistant genes, sequence (ST-167) and plasmid type (IncX3). In India, carbapenems are not used in food animal treatment, hence carbapenem resistant E. coli in piglets possibly originated from the human contact or common environment and is of public health importance.
Sujet(s)
Maladies des agriculteurs/microbiologie , Infections à Escherichia coli/médecine vétérinaire , Escherichia coli/enzymologie , Fèces/microbiologie , Maladies des porcs/transmission , bêta-Lactamases/métabolisme , Maladies des agriculteurs/traitement médicamenteux , Maladies des agriculteurs/épidémiologie , Animaux , Antibactériens/pharmacologie , Études transversales , Escherichia coli/classification , Escherichia coli/génétique , Infections à Escherichia coli/traitement médicamenteux , Infections à Escherichia coli/épidémiologie , Infections à Escherichia coli/transmission , Agriculteurs , Fèces/enzymologie , Femelle , Humains , Inde/épidémiologie , Mâle , Tests de sensibilité microbienne/médecine vétérinaire , Suidae , Maladies des porcs/épidémiologie , Maladies des porcs/microbiologie , Zoonoses/microbiologie , Zoonoses/transmission , bêta-Lactamases/génétiqueRÉSUMÉ
AIMS: We employed a combination of diagnostic tests including single cervical tuberculin test (SCT), rapid lateral-flow test (RT), TB-Feron, conventional PCR and culture to investigate the prevalence of Mycobacterium bovis infections in dairy cattle under the intensive dairy production system in Egypt. METHODS AND RESULTS: In total, 2710 dairy cows from 11 herds in six Governorates were tested by SCT and 444 (16·4%) were TB reactors. Only 65 cows responded to M. bovis antigen by RT and TB-Feron. A postmortem examination showed that 49 (75·4%) of slaughtered cows have visible lesions. Testing of 215 out 444 SCT reactor cows by culture and PCR using blood and milk samples revealed that M. bovis were more frequently identified in the blood (6·1-20·5%) than milk (2·3-5·6%) samples. Additionally, in this study, we investigated the prevalence and potential risk factors associated with M. bovis infection in dairy farm workers. Overall, 100 dairy farm workers were tested using QuantiFERON-TB Gold In-Tube test to detect Mycobacterium tuberculosis complex (MTC) and 35 (35%) were positive. In all, 23 (23%) of MTC positive were M. bovis positive using PCR. Mycobacterium bovis positive cases were associated with workers who had respiratory signs and did not wash or disinfect their hands after handling cows. CONCLUSIONS: The prevalence of M. bovis in dairy cows and dairy farm workers under the intensive dairy production system in Egypt is high. It is therefore essential to disseminate effective prevention and control measures to prevent the spread of M. bovis between dairy cows and dairy workers. SIGNIFICANCE AND IMPACT OF THE STUDY: This study revealed that the use of RT or TB-Feron as an ancillary test of SCT reactor cows resulted in a significant reduction in the SCT false-positive slaughtered cows. A high prevalence of M. bovis infection among farm workers provides evidence of occupational risk in the intensive dairy production system in Egypt.
Sujet(s)
Maladies des agriculteurs/diagnostic , Industrie laitière/statistiques et données numériques , Agriculteurs/statistiques et données numériques , Mycobacterium bovis/isolement et purification , Tuberculose bovine/diagnostic , Maladies des agriculteurs/épidémiologie , Maladies des agriculteurs/microbiologie , Animaux , Bovins , Égypte/épidémiologie , Humains , Mycobacterium bovis/génétique , Mycobacterium bovis/immunologie , Santé au travail , Tuberculose bovine/épidémiologie , Tuberculose bovine/microbiologie , Tuberculose bovine/transmissionRÉSUMÉ
The aim of the present study was to assess the occurrence of MRSA in buffalo dairy farms and in buffalo tank milk from Italy, and to provide information about the antimicrobial resistance profile and molecular characteristics of the isolates. We collected 75 bulk tank milk (BTM) samples from 75 farms and 24 nasal swabs from 24 farm operators. Three (4%) of the 75 BTM samples and 1 (4%) of the 24 human nasal swabs tested positive for MRSA. The milk isolates belonged to the genotypes ST1/t127/Va and ST72/t3092/V, while the human isolate was characterized as ST1/t127/IVa. All isolates were multidrug resistant but vancomycin susceptible; they carried the icaA gene but tested negative for the pvl and ses genes. ST72 is a CA-MRSA commonly found in South Korea, and this is the first report of its detection in Europe. Although we found a low prevalence of MRSA in the farms we surveyed, this study clearly demonstrates, for the first time in Europe, that MRSA can be found in dairy buffalo farms and in raw buffalo milk. Therefore, the risk of human colonization/infection with MRSA linked to the handling of raw milk or consumption of contaminated dairy products should not be ruled out.
Sujet(s)
Maladies des agriculteurs/microbiologie , Staphylococcus aureus résistant à la méticilline/isolement et purification , Lait/microbiologie , Infections à staphylocoques/microbiologie , Maladies des agriculteurs/épidémiologie , Animaux , Antibactériens/pharmacologie , Protéines bactériennes/génétique , Buffles , Multirésistance bactérienne aux médicaments , Agriculteurs , Fermes , Microbiologie alimentaire , Génotype , Humains , Italie/épidémiologie , Staphylococcus aureus résistant à la méticilline/effets des médicaments et des substances chimiques , Staphylococcus aureus résistant à la méticilline/génétique , Tests de sensibilité microbienne , Muqueuse nasale/microbiologie , Prévalence , Infections à staphylocoques/épidémiologieRÉSUMÉ
A 65-year-old male was admitted to the Intensive Care Unit after being resuscitated because of a hypoxic cardiac arrest caused by influenza. Blood cultures taken at time of admission surprisingly grew Bacillus mycoides, a spore-producing apathogenic agriculture bacterium. We collected culture samples at his barge. Although we did not culture Bacillus mycoides, we did find multiple other Bacillus species. We hypothesised that our patient was colonised from the freights of his barge, and bloodstream infection occurred during resuscitation with either the bacterium itself or its spores. To our knowledge, this is the first report on bloodstream infection with Bacillus mycoides in a human patient.
Sujet(s)
Maladies des agriculteurs , Bacillus/isolement et purification , Réanimation/effets indésirables , Sepsie , Vancomycine/administration et posologie , Sujet âgé , Maladies des agriculteurs/diagnostic , Maladies des agriculteurs/microbiologie , Antibactériens/administration et posologie , Hémoculture/méthodes , Arrêt cardiaque/thérapie , Humains , Mâle , Pays-Bas , Réanimation/méthodes , Sepsie/diagnostic , Sepsie/étiologie , Sepsie/microbiologie , Résultat thérapeutiqueRÉSUMÉ
A 35-year-old male patient reached the emergency department after an episode of massive haemoptysis a few hours ago. Fever and dyspnea were mentioned to be present the last 5 days. His medical history included only malaria, successfully treated 2 years ago. Clinical examination revealed high fever, jaundice, cyanosis, tachypnea and bilateral rales on pulmonary auscultation. Laboratory investigation showed high erythrocyte sedimentation rate and C reactive protein, leucocytosis, anaemia, mild thrombocytopaenia, renal impairment, hyperbilirubinaemia and abnormal liver function tests; arterial blood gas analysis showed respiratory alkalosis with severe hypoxia. Thoracic X-ray revealed bilateral pulmonary infiltrates, whereas abdominal and heart ultrasound detected hepatomegaly and small pericardial infusion, respectively. The diagnosis of leptospirosis along with acute respiratory distress syndrome was confirmed by positive IgM Leptospira antibodies. Empirical treatment with triple antibiotic therapy and corticosteroids was applied. The patient was discharged after 1 week, without any symptoms and with almost normal laboratory tests.
Sujet(s)
Hémoptysie/microbiologie , /microbiologie , Maladie de Weil/diagnostic , Maladie aigüe , Adulte , Maladies des agriculteurs/diagnostic , Maladies des agriculteurs/microbiologie , Antibactériens/usage thérapeutique , Diagnostic différentiel , Association de médicaments , Humains , Mâle , Maladie de Weil/traitement médicamenteuxRÉSUMÉ
Cryptococcal meningitis is an opportunistic infection predominantly affecting immunocompromised patients but rarely can affect the immunocompetent. We describe a 53-year-old Caucasian man who presented complaining of a 2-week history of severe bilateral eye pain and diplopia. His only known risk factor was that he lived in a horse farm and recently shot bats and pigeons in his barn. He visited an outside hospital during this time without a diagnosis established. After further deliberation, we obtained a lumbar puncture (LP) which revealed an opening pressure (OP) of 27 cm H2O. Cerebrospinal fluid (CSF) and fungal cultures confirmed the presence of Cryptococcus neoformans The patient was diagnosed with C. neoformans-mediated meningoencephalitis and was initiated on the appropriate induction anti-fungal therapy. This case emphasises the need for clinicians to remain vigilant and consider cryptococcal meningitis in immunocompetent individuals even when classic symptoms of meningitis are absent.
Sujet(s)
Maladies des agriculteurs/diagnostic , Immunocompétence/physiologie , Méningite cryptococcique/diagnostic , Méningoencéphalite/diagnostic , Maladies des agriculteurs/traitement médicamenteux , Maladies des agriculteurs/microbiologie , Amphotéricine B/administration et posologie , Antifongiques/administration et posologie , Cryptococcus neoformans , Diplopie/microbiologie , Association de médicaments , Douleur oculaire/microbiologie , Fluconazole/administration et posologie , Humains , Mâle , Méningite cryptococcique/traitement médicamenteux , Méningoencéphalite/traitement médicamenteux , Méningoencéphalite/microbiologie , Adulte d'âge moyen , Infections opportunistes/diagnostic , Infections opportunistes/traitement médicamenteux , Maladies raresRÉSUMÉ
A contaminação de ordenhadores por Staphylococcus spp. tem sido descrita como um fator de risco para infecções intramamárias em animais durante o procedimento de ordenha. Objetivou-se avaliar a colonização por Staphylococcus spp. da região palmar/interdigital e da cavidade nasal em funcionários de ordenha de propriedades leiteiras no Município de Venturosa-PE. Foram coletadas amostras de swab nasal e das mãos de funcionários (n=6) de três propriedades leiteiras. Em todas as amostras de swab nasal (6/6) e em 33,3% (2/6) de swab das mãos foram isolados Staphylococcus spp. Além disso, todos os isolados foram classificados como Staphylococcus Coagulase Negativo (SCN), o que indica a disseminação desses micro-organismos.
Sujet(s)
Humains , Animaux , Fosse nasale/microbiologie , Infections à staphylocoques , Main/microbiologie , Staphylococcus/isolement et purification , Maladies des agriculteurs/microbiologieRÉSUMÉ
Brucellosis is being increasingly recognized after solid organ transplantation but has not been reported after orthotopic heart transplantation. We present the case of a 51-year-old farmer who underwent orthotopic heart transplantation and was readmitted after 3 months in a severely immunosuppressed state with significant nonspecific complaints. He posed a diagnostic and management dilemma to all disciplines, but finally turned out to be harboring Brucella infection. He responded well to medical management and was discharged in a stable clinical status. Although rare, brucellosis should be included in the investigative workup for nonspecific symptoms after cardiac transplantation.
Sujet(s)
Maladies des agriculteurs/diagnostic , Brucellose/diagnostic , Transplantation cardiaque , Complications postopératoires/diagnostic , Maladies des agriculteurs/étiologie , Maladies des agriculteurs/microbiologie , Animaux , Antibactériens/usage thérapeutique , Anticorps antibactériens/sang , Brucella/immunologie , Brucellose/sang , Brucellose/traitement médicamenteux , Brucellose/étiologie , Protéine C-réactive/analyse , Bovins , Produits laitiers/microbiologie , Retard de diagnostic , Doxycycline/usage thérapeutique , Association de médicaments , Humains , Sujet immunodéprimé , Immunoglobuline M/sang , Immunosuppresseurs/effets indésirables , Hyperleucocytose/étiologie , Mâle , Adulte d'âge moyen , Complications postopératoires/sang , Complications postopératoires/traitement médicamenteux , Complications postopératoires/étiologie , Association triméthoprime-sulfaméthoxazole/usage thérapeutiqueSujet(s)
Maladies des agriculteurs/étiologie , Agriculture/instrumentation , Contamination de matériel , Francisella tularensis , Maladies du pharynx/étiologie , Tularémie/étiologie , Vitis/microbiologie , Zoonoses/transmission , Adolescent , Adulte , Maladies des agriculteurs/microbiologie , Animaux , Enfant , Femelle , Allemagne , Humains , Mâle , Souris , Maladies du pharynx/microbiologie , Loi de Poisson , Facteurs de risque , Vin , Jeune adulteSujet(s)
Maladies des agriculteurs/microbiologie , Blastomycose sud-américaine/diagnostic , Maladies testiculaires/microbiologie , Adulte , Maladies des agriculteurs/diagnostic , Maladies des agriculteurs/traitement médicamenteux , Amphotéricine B/usage thérapeutique , Antifongiques/usage thérapeutique , Biopsie , Humains , Imagerie par résonance magnétique , Mâle , Blastomycose sud-américaine/traitement médicamenteux , Maladies testiculaires/diagnostic , Maladies testiculaires/traitement médicamenteux , Tomodensitométrie , Association triméthoprime-sulfaméthoxazole/usage thérapeutiqueRÉSUMÉ
Streptococcus suis is a re-emerging zoonotic pathogen that may cause severe disease, mostly meningitis, in pigs and in humans having occupational contact with pigs and pork, such as farmers, slaughterhose workers and butchers. The first stage of the pathogenic process, similar in pigs and humans, is adherence to and colonisation of mucosal and/or epithelial surface(s) of the host. The second stage is invasion into deeper tissue and extracellular translocation of bacterium in the bloodstream, either free in circulation or attached to the surface of monocytes. If S. suis present in blood fails to cause fatal septicaemia, it is able to progress into the third stage comprising penetration into host's organs, mostly by crossing the blood-brain barrier and/or blood-cerebrospinal fluid barrier to gain access to the central nervous system (CNS) and cause meningitis. The fourth stage is inflammation that plays a key role in the pathogen esis of both systemic and CNS infections caused by S. suis. The pathogen may induce the overproduction of pro-inflammatory cytokines that cause septic shock and/or the recruitment and activation of different leukocyte populations, causing acute inflammation of the CNS. Streptococcus suis can also evoke - through activation of microglial cells, astrocytes and possibly other cell types - a fulminant inflammatory reaction of the brain which leads to intracranial complications, including brain oedema, increased intracranial pressure, cerebrovascular insults, and deafness, as a result of cochlear sepsis. In all stages of the pathogenic process, S. suis interacts with many types of immunocompetent host's cells, such as polymorphonuclear leukocytes, mononuclear macrophages, lymphocytes, dendritic cells and microglia, using a range of versatile virulence factors for evasion of the innate and adaptive immune defence of the host, and for overcoming environmental stress. It is estimated that S. suis produces more than 100 different virulence factors that could be classified into 4 groups: surface components or secreted elements, enzymes, transcription factors or regulatory systems and transporter factors or secretion systems. A major virulence factor is capsular polysaccharide (CPS) that protects bacteria from phagocytosis. However, it hampers adhesion to and invasion of host's cells, release of inflammatory cytokines and formation of the resistant biofilm which, in many cases, is vital for the persistence of bacteria. It has been demonstrated that the arising by mutation unencapsulated S. suis clones, which are more successful in penetration to and propagation within the host's cells, may coexist in the organism of a single host together with those that are encapsulated. Both 'complementary' clones assist each other in the successful colonization of host's tissues and persistence therein. S. suis has an open pan-genome characterized by a frequent gene transfer and a large diversity. Of the genetic determinants of S. suis pathogenicity, the most important are pathogenicity islands (PAI), in particular, a novel DNA segment of 89 kb length with evident pathogenic traits that has been designated as 89K PAI. It has been estimated that more than one-third of the S. suis virulence factors is associated with this PAI. It has been proved that the virulent S. suis strains possess smaller genomes, compared to avirulent ones, but more genes associated with virulence. Overall, the evolution of the species most probably aims towards increased pathogenicity, and hence the most significant task of the current research is an elaboration of a vaccine, efficient both for humans and pigs.
Sujet(s)
Maladies des agriculteurs/microbiologie , Exposition professionnelle/effets indésirables , Infections à streptocoques/microbiologie , Streptococcus suis/physiologie , Maladies des porcs/microbiologie , Zoonoses/microbiologie , Animaux , Humains , Infections à streptocoques/transmission , Streptococcus suis/génétique , Streptococcus suis/isolement et purification , Streptococcus suis/pathogénicité , Suidae , Virulence , Facteurs de virulence/génétique , Facteurs de virulence/métabolisme , Zoonoses/transmissionRÉSUMÉ
A remarkable case of onychomycosis by Trichophyton (T.) rubrum combined with nail infestation by Tyrophagus (T.) putrescentiae in an elderly diabetic farmer is described and discussed. Large numbers of eggs and mites in all development stages were present in nail debris, reflecting active reproduction on site. Treatment with ivermectin 0.1% cream and environmental decontamination cleared the mite infestation, while onychomycosis responded well to oral terbinafine and ciclopirox 8% nail lacquer. Such a combination of onychomycosis and mite infestation of the same nail is an exceptional finding reported only twice in the literature.
Sujet(s)
Dermatoses du pied/complications , Acarioses/complications , Ongles/parasitologie , Onychomycose/complications , Pied d'athlète/complications , Trichophyton/isolement et purification , Sujet âgé , Maladies des agriculteurs/traitement médicamenteux , Maladies des agriculteurs/microbiologie , Élevage , Antifongiques/usage thérapeutique , Ciclopirox , Diabète de type 2/complications , Prédisposition aux maladies , Dermatoses du pied/microbiologie , Humains , Ivermectine/usage thérapeutique , Mâle , Naphtalènes/usage thérapeutique , Onychomycose/microbiologie , Perméthrine , Pyridones/usage thérapeutique , Chaussures , Terbinafine , Pied d'athlète/microbiologieRÉSUMÉ
BACKGROUND:: Histological and mycological changes during itraconazole use have not been totally established in chromoblastomycosis. OBJECTIVES:: To evaluate tissue modifications in chromoblastomycosis carriers under itraconazole treatment. METHODS:: A histological retrospective study of 20 cases of chromoblastomycosis seen at the university hospital at the south of Brazil, during itraconazole 400 mg daily treatment. Patients were classified into two groups: plaque or tumor lesions, and underwent periodic evaluations every four months during three years. Hematoxylin-eosin stain was used to analyze epidermal modifications, inflammatory infiltrate and fibrosis, and Fontana-Masson stain for parasite evaluation. RESULTS:: Fontana-Masson stain was superior to hematoxylin-eosin stain in fungal count in the epidermis (mean difference=0.14; p<0.05). The most distinct mycosis tissue responses were registered in the dermis. Epidermal thinning, granulomatous infiltrate decrease or disappearance, fibrosis increase and quantitative/morphological changes occurred during treatment. STUDY LIMITATIONS:: Patients could not be located to have their current skin condition examined. CONCLUSION:: Parasitic and tissue changes verified in this study can reflect the parasite-host dynamics under itraconazole action.
Sujet(s)
Maladies des agriculteurs/traitement médicamenteux , Maladies des agriculteurs/microbiologie , Antifongiques/usage thérapeutique , Chromoblastomycose/traitement médicamenteux , Itraconazole/usage thérapeutique , Peau/anatomopathologie , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Maladies des agriculteurs/anatomopathologie , Biopsie , Chromoblastomycose/microbiologie , Chromoblastomycose/anatomopathologie , Femelle , Champignons/physiologie , Interactions hôte-parasite/physiologie , Humains , Mâle , Adulte d'âge moyen , Études rétrospectives , Nitrate d'argent , Peau/microbiologie , Tissu sous-cutanéSujet(s)
Antibactériens/usage thérapeutique , Infections à mycobactéries non tuberculeuses/traitement médicamenteux , Ténosynovite/traitement médicamenteux , Adulte , Maladies des agriculteurs/traitement médicamenteux , Maladies des agriculteurs/microbiologie , Association amoxicilline-clavulanate de potassium/usage thérapeutique , Antibactériens/administration et posologie , Clarithromycine/usage thérapeutique , Contre-indications aux médicaments , Résistance bactérienne aux médicaments , Substitution de médicament , Traumatismes du doigt/complications , Traumatismes du doigt/microbiologie , Humains , Mâle , Infections à mycobactéries non tuberculeuses/étiologie , Blessures professionnelles/microbiologie , Ténosynovite/étiologie , Ténosynovite/microbiologie , Association triméthoprime-sulfaméthoxazole/usage thérapeutique , Infection de plaie/complications , Infection de plaie/microbiologieRÉSUMÉ
Abstract: Background: Histological and mycological changes during itraconazole use have not been totally established in chromoblastomycosis. Objectives: To evaluate tissue modifications in chromoblastomycosis carriers under itraconazole treatment. Methods: A histological retrospective study of 20 cases of chromoblastomycosis seen at the university hospital at the south of Brazil, during itraconazole 400 mg daily treatment. Patients were classified into two groups: plaque or tumor lesions, and underwent periodic evaluations every four months during three years. Hematoxylin-eosin stain was used to analyze epidermal modifications, inflammatory infiltrate and fibrosis, and Fontana-Masson stain for parasite evaluation. Results: Fontana-Masson stain was superior to hematoxylin-eosin stain in fungal count in the epidermis (mean difference=0.14; p<0.05). The most distinct mycosis tissue responses were registered in the dermis. Epidermal thinning, granulomatous infiltrate decrease or disappearance, fibrosis increase and quantitative/morphological changes occurred during treatment. Study limitations: Patients could not be located to have their current skin condition examined. Conclusion: Parasitic and tissue changes verified in this study can reflect the parasite-host dynamics under itraconazole action.
Sujet(s)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Sujet âgé , Sujet âgé de 80 ans ou plus , Peau/anatomopathologie , Chromoblastomycose/traitement médicamenteux , Itraconazole/usage thérapeutique , Maladies des agriculteurs/microbiologie , Maladies des agriculteurs/traitement médicamenteux , Antifongiques/usage thérapeutique , Nitrate d'argent , Peau/microbiologie , Biopsie , Études rétrospectives , Chromoblastomycose/microbiologie , Chromoblastomycose/anatomopathologie , Tissu sous-cutané , Maladies des agriculteurs/anatomopathologie , Champignons/physiologie , Interactions hôte-parasite/physiologieRÉSUMÉ
PURPOSE OF REVIEW: Invasive aspergillosis is a worldwide disease that primarily affects immune-compromised patients, agricultural workers with corneal abrasions, individuals with structural lung disease, and patients with primary immune deficiency. The critical function of the immune system is to prevent the germination of airborne conidia into tissue-invasive hyphae. This review covers recent advances that shape our understanding of anti-Aspergillus immunity at the molecular and cellular level. RECENT FINDINGS: Host defense against conidia and hyphae occurs via distinct molecular mechanisms that involve intracellular and extracellular killing pathways, as well as cooperation between different myeloid cell subsets. The strength and efficacy of the host response is shaped by the tissue microenvironment. In preclinical models of disease, host immune augmentation strategies have yielded benefits, yet translating these insights into therapeutic strategies in humans remains challenging. SUMMARY: Although advances in early diagnostic strategies and in antifungal drugs have ameliorated clinical outcomes of invasive aspergillosis, further improvements depend on gaining deeper insight into and translating advances in anti-Aspergillus immunity.