Document Detail


Adiaspiromycosis causing respiratory failure and a review of human infections due to Emmonsia and Chrysosporium spp.
MedLine Citation:
PMID:  22259200     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report a case of a 27-year-old male who presented with respiratory distress that required mechanical ventilation. Transbronchial biopsy revealed adiaspores of the fungus Emmonsia crescens within granulomata, a condition known as adiaspiromycosis. The patient received amphotericin products and corticosteroids, followed by itraconazole, and made a full recovery. Emmonsia crescens is a saprobe with a wide distribution that is primarily a rodent pathogen. The clinical characteristics of the 20 cases of human pulmonary adiaspiromycosis reported since the last comprehensive case review in 1993 are described here, as well as other infections recently reported for the genus Emmonsia. Pulmonary adiaspiromycosis has been reported primarily in persons without underlying host factors and has a mild to severe course. It remains uncertain if the optimal management of severe pulmonary adiaspiromycosis is supportive or if should consist of antifungal treatment, corticosteroids, or a combination of the latter two. The classification of fungi currently in the genus Emmonsia has undergone considerable revision since their original description, including being grouped with the genus Chrysosporium at one time. Molecular genetics has clearly differentiated the genus Emmonsia from the Chrysosporium species. Nevertheless, there has been a persistent confusion in the literature regarding the clinical presentation of infection with fungi of these two genera; to clarify this matter, the reported cases of invasive Chrysosporium infections were reviewed. Invasive Chrysosporium infections typically occur in impaired hosts and can have a fatal course. Based on limited in vitro susceptibility data for Chrysosporium zonatum, amphotericin B is the most active drug, itraconazole susceptibility is strain-dependent, and fluconazole and 5-fluorocytosine are not active.
Authors:
Gregory M Anstead; Deanna A Sutton; John R Graybill
Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2012-01-18
Journal Detail:
Title:  Journal of clinical microbiology     Volume:  50     ISSN:  1098-660X     ISO Abbreviation:  J. Clin. Microbiol.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-19     Completed Date:  2012-07-10     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  7505564     Medline TA:  J Clin Microbiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1346-54     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Infectious Diseases, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA. anstead@uthscsa.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Amphotericin B / therapeutic use
Antifungal Agents / therapeutic use
Chrysosporium*
Granuloma / drug therapy,  microbiology,  radiography*
Humans
Lung Diseases, Fungal / drug therapy,  microbiology,  radiography*
Male
Respiratory Insufficiency / drug therapy,  microbiology,  radiography*
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/liposomal amphotericin B; 1397-89-3/Amphotericin B
Comments/Corrections

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