[Optimization of variables in photodynamic antifungal assays against Candida species]. / Optimización de variables en ensayos de actividad antifúngica fotodinámica frente a especies de Candida.

Oral infections due to yeasts of the genus Candida are very common in patients with predisposing factors, such as physiological conditions or certain underlying diseases. Moreover, oral candidiasis can also evolve into disseminated forms. In this work, strains of the genus Candida were studied to establish the optimal radiation conditions for photosensitizing compounds, in a photodynamic antifungal therapy protocol. A total of 39 isolates were evaluated. The strains were exposed to twelve dyestuffs, eight radiation sources and three different exposure times. Orthotoluidine blue exhibited good photodynamic activity, in combination with exposure to a 20W reflector lamp LED (light-emitting diode) light for 60minutes. When considering the difficulties of using conventional antifungal drugs, the emergence of resistant strains, recurrences, and adverse reactions of certain commonly used drugs, the photodynamic antifungal therapy is a promising strategy for the treatment of localized infections.

[Scedosporium spp. osteomyelitis: A case report]. / Osteomielitis por Scedosporium spp., a propósito de un caso.

Scedosporium is a fungus that has a worldwide distribution, and which can be found in soil and contaminated water. It can rarely affect bone tissue and can do it either by direct inoculation or through trauma. We present here a case of a 54- year- old male patient with a diagnosis of chronic bacterial osteomyelitis due to an aquatic accident and exposed fracture of tibia-fibula of both members, which was treated with broad-spectrum antibiotics for 120 days. Eight months after the onset of the disease, Scedosporium spp. was isolated from the collection of one of the affected member, which was treated with voriconazole in combination with terbinafine.

Scedosporium boydii finding in an immunocompromised patient and review of the literature.

BACKGROUND: Scedosporiasis is an emerging mycosis that has gained importance in recent years due to its worldwide prevalence. It is caused by species of the Scedosporium apiospermum complex. These species can cause opportunistic infections in immunocompromised patients and, occasionally, in immunocompetent patients as well. The high intrinsic antifungal resistance make these infections difficult to manage. AIMS: The objective of this study was to interpret the mycological findings in a transplant patient, together with the images obtained in the radiological studies, in order to provide an early and effective antifungal therapy. METHODS: The mycological analysis of samples taken from a heart transplant patient with radiological images suggesting a fungal infection was performed. Computed tomography scan of the head and thorax showed space-occupying lesions in both the frontal lobe and cerebellum, and multiple pulmonary nodules. The nodules were punctured and the samples obtained were analyzed according to the procedures for mycological analysis. The identity of the isolates was confirmed by nucleotide sequencing. Eventually, the antifungal susceptibility was studied. RESULTS: The fungal isolates obtained, whose identity was confirmed by sequencing, belonged to the species Scedosporium boydii. Injured tissues were surgically removed and a treatment with amphotericin B and voriconazole-minimum inhibitory concentration (MIC) 0.5µg/mL and ≥0.5µg/mL respectively - was administered. CONCLUSIONS: Although the patient died due to complications of a Klebsiella pneumoniae sepsis refractory to treatment, the progression of the fungal disease, although slow, was favourable in the early phases of the treatment due to a correct diagnosis and the antifungal susceptibility test carried out. Clinical cases of this nature highlight the need to increase the epidemiological study of these microorganisms, as well as the proper treatment of the diseases caused, in order to achieve early diagnoses that reduce the morbidity and mortality of patients.

Osteomielitis por Scedosporium spp., a propósito de un caso / Scedosporium spp. osteomyelitis: A case report

Resumen Scedosporium es un hongo de distribución mundial que se encuentra en el suelo y enaguas contaminadas. Raramente afecta tejido óseo y puede hacerlo por inoculación directa através de traumatismos. Se presenta el caso clínico de un paciente de 54 a˜nos con antecedentede accidente acuático y fractura expuesta de tibia-peroné de ambos miembros inferiores, condiagnóstico de osteomielitis crónica bacteriana tratada con antibióticos de amplio espectropor 120 días. Luego de ocho meses iniciado el cuadro, se aísla Scedosporium spp. en colecciónde miembro afectado; por tal motivo, el paciente recibe terapia con voriconazol asociado aterbinafina.© 2019 Asociacion Argentina de Microbiologıa. Publicado por Elsevier Espana, S.L.U. Este es unarticulo Open Access bajo la licencia CC BY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Abstract Scedosporium is a fungus that has a worldwide distribution, and which can be foundin soil and contaminated water. It can rarely affect bone tissue and can do it either by directinoculation or through trauma. We present here a case of a 54- year- old male patient with adiagnosis of chronic bacterial osteomyelitis due to an aquatic accident and exposed fracture of tibia-fibula of both members, which was treated with broad-spectrum antibiotics for 120days. Eight months after the onset of the disease, Scedosporium spp. was isolated from thecollection of one of the affected member, which was treated with voriconazole in combinationwith terbinafine.© 2019 Asociacion Argentina de Microbiologıa. Published by Elsevier Espana, S.L.U. This is anopen access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Scedosporium boydii finding in an immunocompromised patient and review of the literature / Hallazgo de Scedosporium boydii en un paciente inmunocomprometido y revisión de la literatura

Background Scedosporiasis is an emerging mycosis that has gained importance in recent years due to its worldwide prevalence. It is caused by species of the Scedosporium apiospermum complex. These species can cause opportunistic infections in immunocompromised patients and, occasionally, in immunocompetent patients as well. The high intrinsic antifungal resistance make these infections difficult to manage. Aims The objective of this study was to interpret the mycological findings in a transplant patient, together with the images obtained in the radiological studies, in order to provide an early and effective antifungal therapy. Methods The mycological analysis of samples taken from a heart transplant patient with radiological images suggesting a fungal infection was performed. Computed tomography scan of the head and thorax showed space-occupying lesions in both the frontal lobe and cerebellum, and multiple pulmonary nodules. The nodules were punctured and the samples obtained were analyzed according to the procedures for mycological analysis. The identity of the isolates was confirmed by nucleotide sequencing. Eventually, the antifungal susceptibility was studied. Results The fungal isolates obtained, whose identity was confirmed by sequencing, belonged to the species Scedosporium boydii. Injured tissues were surgically removed and a treatment with amphotericin B and voriconazole-minimum inhibitory concentration (MIC) 0.5μg/mL and ≥0.5μg/mL respectively – was administered. Conclusions Although the patient died due to complications of a Klebsiella pneumoniae sepsis refractory to treatment, the progression of the fungal disease, although slow, was favourable in the early phases of the treatment due to a correct diagnosis and the antifungal susceptibility test carried out. ... (AU)

Antecedentes La escedosporiasis es una micosis emergente de relevancia en los últimos años por su prevalencia mundial. Es causada por especies del complejo Scedosporium apiospermum (S. apiospermum), que pueden provocar infecciones oportunistas de difícil tratamiento en pacientes inmunocomprometidos y, ocasionalmente, en inmunocompetentes. El alto grado de resistencia intrínseca de las especies de este complejo dificulta el manejo de las infecciones. Objetivos Interpretar los hallazgos micológicos en un paciente trasplantado, en conjunción con los estudios radiológicos, a fin de instaurar una terapia antifúngica precoz y efectiva. Métodos Se realizó el estudio micológico de muestras de un paciente con trasplante cardiaco, cuyos exámenes radiológicos eran compatibles con una infección fúngica. La tomografía axial computarizada de cabeza y tórax mostró masas ocupantes en el lóbulo frontal y el cerebelo, así como múltiples nódulos pulmonares. Se punzaron las mismas y se procesó de acuerdo con el protocolo de análisis micológico de rutina; la identidad de los aislamientos se confirmó por secuenciación nucleotídica. Finalmente se evaluó la sensibilidad antifúngica. Resultados La identidad de los aislamientos fúngicos obtenidos fue Scedosporium boydii (S. boydii). Se procedió a la remoción quirúrgica del tejido afectado y se puso un tratamiento con anfotericina B y voriconazol, para los cuales los valores de concentración inhibitoria mínima del aislamiento fueron 0,5 μg/mL y ≥ 0,5 μg/mL, respectivamente. Conclusiones Si bien el paciente falleció por complicaciones asociadas a sepsis por Klebsiella pneumoniae (K. pneumoniae) refractaria al tratamiento, la evolución del cuadro micológico, aun siendo lenta, progresó favorablemente en las primeras fases del tratamiento. Esto se atribuye a un correcto diagnóstico y evaluación de la sensibilidad antifúngica del hongo aislado. ... (AU)