Otomycosis caused by the cryptic and emerging species Aspergillus sydowii: two case reports.

Two cases of otomycosis have been reported in patients undergoing tympanomastoidectomy. The first one had chronic otitis media, hypertrophic concha and nasal septum deviation, tympanic perforation and otorrhea. The second had otalgia, pruritus, chronic otitis media and cholesteatoma. Direct examination showed mycelial septate filaments with a branch at an angle close to 45°, later identified as Aspergillus sydowii by sequencing the BenA and CaM genes. Susceptibility testing showed low MIC of amphotericin B, itraconazole, ketoconazole and ciclopirox olamine. In both cases, ketoconazole was instituted for 10 days. Otomycosis is a challenge as it is primarily recurrent in patients undergoing surgery. The clinical implication, the identification of the emerging pathogen and the determination of MIC were necessary for the knowledge of the epidemiological profile and establishment of the treatment.

Aspergillus are fungi that can cause ear disease. In severe infections, these fungi can be present for long periods inside the ear, and commonly belong to the species Aspergillus section Nigri and Aspergillus flavus. In this work, we present two cases of ear infections by a different species, Aspergillus sydowii. Patients had obstructed nasal cavities, crooked internal separation of the nose and complaints of secretion in the ear. The efficient diagnosis allowed a treatment that resulted in the death of the fungus and the cure of the patient.

Trichosporon inkin fungemia case report: clinical and laboratory management.

Trichosporon species are emerging as opportunistic pathogens that mainly affect immunocompromised patients. Patients with onco-hematological diseases usually present with fungemia by Trichosporon species, especially by T. asahii. Reports of this infection by other species of the genus are uncommon. Thus, in this paper, we present a case of T. inkin fungemia in a 39-year-old female patient with intestinal obstruction and absence of malignant hematological diseases. The late mycological diagnosis, the ineffective control of her pre-existing conditions and consequent failure to start antifungal therapy were the contributing factors for the patient's death.

Lay abstract Trichosporon species have been emerged as opportunistic fungi that mainly affect patients with low immunity. Hematological (blood related) cancer patients usually present with bloodstream infection with Trichosporon species, particularly Trichosporon asahii. Reports of this infection by other species of the genus are uncommon. Thus, in this paper, we present a case of bloodstream infection by Trichosporon inkin in a 39-year-old female patient with intestinal obstruction and absence of hematological cancer. The late fungal diagnosis, the ineffective control of the first symptoms and consequent failure to start specific medication were the factors that led to the patient's death.

Control of bacterial and fungal biofilms by natural products of Ziziphus joazeiro Mart. (Rhamnaceae).

The aim of this study is to verify the action of the aqueous leaf extract Ziziphus joazeiro in the eradication of bacterial and fungal biofilms, and to compare these effects with the stem bark extracts, as well as with conventional standard drugs. The presence of secondary metabolites was observed through phytochemical prospection assays. The effect of the aqueous extract on microbial biofilm formation was observed by OD600 nm absorbance and the crystal violet assay. For bacterial and fungal biofilms, chlorhexidine gluconate and fluconazole, respectively, were used as positive controls. Phytochemical characterization showed the presence of secondary metabolite classes common to both extracts such as flavonoids, steroids and saponins. In particular, in the aqueous leaf extract phenols, condensed tannins and alkaloids were observed. Eradication results using the aqueous leaf extract showed an inhibition of the microbial biofilm mass, moreover the biofilms were more sensitive to the bark extract, which presented a greater inhibition number and an action similar to standard drugs. It is important to highlight the leaf extract showed significant eradication at the lowest concentrations for mature yeast biofilms, thus demonstrating its potential to modify microbial resistance susceptibility. Bacterial and fungal biofilm eradication results using the Ziziphus joazeiro aqueous extracts presented a biofilm inhibition effect for both, moreover the results support the ethnopharmacological knowledge surrounding the use of Ziziphus joazeiro stems in the community. In comparison, the bark extract presented a more effective treatment than the leaf extract against biofilms, presenting inhibition levels similar to the used standard drugs.