A new case of occupational asthma caused by Chrysonilia sitophila (asexual state of Neurospora sitophila) was diagnosed by molecular identification of the mold and confirmed by skin prick test, peak expiratory flow rate measurements, and experimental immunoglobulin E analysis. CASE REPORTA 43-year-old previously healthy man, who was a nonsmoker, was examined for repetitive episodes of coughing, dyspnea, rhinitis, and conjunctivitis related to his job. He was employed as a coffee dispenser operator for 13 years. His job consisted of emptying containers of coffee grounds and placing new powdered coffee into beverage dispensers. After 9 years of employment, he developed respiratory and ophthalmological symptoms when he collected coffee grounds that had been stored for longer than a week. These coffee grounds were covered with an orange powder, which dispersed into the air when he cleaned the machine. He had no symptoms during weekends and holidays or when the coffee dispenser was emptied frequently and the coffee grounds were not covered by the orange powder.The patient had no history of rhinitis or asthma. He had no pets at home and stopped smoking 15 years ago. His father and sister have a history of pollen rhinitis.We performed a mycological analysis of the orange powder covering a coffee grounds sample brought by the patient. Only one type of mold grew quickly and displayed floccose salmoncolored colonies. Microscopic examination showed septate hyphae with lateral branches forming chains of conidia and arthroconidia. These aspects are characteristic of Chrysonilia sitophila, as described by de Hoog et al. (2). The last colonies were subcultured successively twice to obtain pure cultures of C. sitophila. A fresh coffee sample, brought by the patient was examined for fungal culture and was negative. DNA extraction, amplification, and sequencing of the intergenic transcribed spacer and 5.8S regions of fungal ribosomal genes were performed from the pure culture (8). The nucleotide sequence obtained was deposited in GenBank and aligned and compared with reference sequences present in the database, using Basic Local Alignment Search Tool (BLAST) searches at the National Center for Biotechnology Information (NCBI) web interface (http://blast.ncbi.nlm.nih.gov/Blast.cgi). Molecular diagnosis confirmed the mycological identification.Skin prick tests (SPTs) were performed with 20 common aeroallergens and included phosphate codeine (positive) and saline (negative) as controls. SPTs were positive for extracts of grass pollen and birch pollen (Stallergènes, France), revealing wheal and flare responses of 7/30 mm and 5/30 mm, respectively. SPTs were negative for mold extracts of Alternaria and Cladosporium. The SPT with the coffee grounds covered by the orange powder, prepared as a 1/100 (wt/vol) solution and diluted 1/10, was positive and induced a wheal and flare response of 7/25 mm. The SPT with a fresh coffee sample brought by the patient was negative.Basal spirometry and chest X ray were normal. Nonspecific bronchial cha...

Pre-exposure rabies prophylaxis (PrEP) is recommended for people at frequent or increased risk of professional exposure to lyssavirus (including rabies virus). PrEP provides protection against unrecognized exposure. After the primary vaccination, one’s immune response against rabies may decline over time. We aimed to evaluate the immune response to rabies in individuals immunized for occupational reasons before and after a booster dose of the rabies vaccine. With this aim, we retrospectively documented factors associated with an inadequate response in individuals vaccinated for occupational purposes. Our findings analyzed data from 498 vaccinated individuals and found that 17.2% of participants had an inadequate antibody titration documented after their primary vaccination without the booster, while inadequate response after an additional booster of the vaccine was evidenced in 0.5% of tested participants. This study showed that a single booster dose of vaccine after PrEP conferred a high and long-term immune response in nearly all individuals except for rare, low responders. A systematic rabies booster after primary vaccination may result in alleviating the monitoring strategy of post-PrEP antibody titers among exposed professionals.

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