The aim of this work was to describe the distribution of the members of the Cryptococcus species complex (Cryptococcus neoformans and C. gattii) in hollows of trees from seven parks in Buenos Aires City, to determine the serotypes and genotypes of these environmental isolates and to compare them with the ones reported in the 2001 survey. Four hundred and eighty nine samples were collected by swabbing all trees which had hollows or fissures in the seven parks studied. Each tree was sampled once during the study period and one or more isolates were recovered from each swab. Eight isolates of C. neoformans and 18 isolates of C. gattii were recovered from 15 out of 489 tree samples. C. neoformans was isolated from Tipuana tipu, Eucalyptus spp., and Phoenix sp. All isolates were serotype A and belonged to genotype VNI. C. gattii was isolated from Tipuana tipu, Cedrus deodara, Eucalyptus spp., Acacia visca, Cupresus sempervirens and Ulmus campestrus. All isolates were serotype B and genotype VGI, like both C. gattii strains isolated in 2001. On two occasions, both species were isolated from the same tree sample. These results reinforce and extend our previous findings especially about the presence of C. gattii serotype B, genotype VGI, in Argentina.
A 2-year-old female Border collie was examined for dermatitis with a partial alopecic zone around her left front member. Six months later the lesion became swollen, alopecic with ulcerated areas. Microscopy analysis of samples showed numerous non-septate, branching, thin-walled and irregular shaped hyphal elements. Fungal cultures and molecular studies identified Saksenaea vasiformis. Treatments with griseofulvin, itraconazole and surgical debridement were used, however, fourteen months later the dog was euthanatized because of the unfavorable clinical outcome.
M ucormycosis is a debilitating fungal infection; the mortality rate among persons with predisposing factors such as skin trauma (e.g., surgery), diabetes mellitus, or organ transplant is high. The fungus can be directly inoculated into a wound or inhaled (1-3). Rhizopus spp. are the Mucorales fungi that most commonly cause mucormycosis (1,2,4) and are the most common non-Aspergillus cause of invasive filamentous fungal infections (5). However, although Mucorales fungi are ubiquitous in the environment, mucormycosis is relatively uncommon. Rhizopus microsporus has been shown to be a cause of serious infections after anterior cruciate ligament reconstruction surgeries in Argentina (6,7). A recent review of 40 Rhizopus-associated cases of osteomyelitis that developed after these surgeries from 2005 through 2017 in several regions across Argentina identified 3 species-R. microsporus var. rhizopodiformis, R. microsporus var. microsporus, and R. arrhizus [syn. R. oryzae]-and implicated healthcare practices and facility shortcomings in the infections (8). Limited molecular analyses of osteomyelitis-associated R. microsporus infections identified commonalities among isolated strains (7); however, no genomic epidemiologic analyses have been performed on this nosocomial cluster. In this study, we analyzed the genomes of R. microsporus var. rhizopodiformis isolates from patients from multiple facilities in Argentina in the context of unrelated controls from outside the geographic area to empirically establish the relationships among them and determine whether infections may have originated from a common source. Materials and Methods During 2006-2014, we collected 24 R. microsporus isolates from patients at 14 healthcare facilities in 10 provinces in Argentina (8). For unrelated control isolates, used to establish genomic context for the nosocomial cluster in Argentina, we selected 13 isolates from the US Centers for Disease Control and Prevention (Atlanta, GA, USA), collected from 2003 through 2015 (Table). We extracted DNA from the 37 isolates by using a DNeasy Blood and Tissue Kit (QIAGEN, https:// www.qiagen.com), according to the manufacturer's
We report the first case of maxillary sinusitis caused by Actinomucor elegans in an 11-year-old patient. Histopathological and mycological examinations of surgical maxillary sinuses samples showed coenocytic hyphae characteristic of mucoraceous fungi. The fungi recovered had stolons and rhizoids, nonapophyseal and globose sporangia, and whorled branched sporangiophores and was identified as A. elegans. After surgical cleaning and chemotherapy with amphotericin B administered intravenously and by irrigation, the patient became asymptomatic and the mycological study results were negative.An 11-year-old female patient, being neither diabetic nor human immunodeficiency virus positive, without evident underlying disease, but with slight leukopenia, was brought to a specialist about left-eye epiphora. On physical examination, the patient reported serosanguinous nasal discharge and decreased sinus ventilation lasting 2 months. A magnetic resonance imaging (MRI) study revealed left pansinusitis, and nonspecific treatment was initiated. One month after the first clinical examination, the patient spontaneously expelled seromucous material during a cough. The presence of coenocytic hyphae in a direct examination of this sample, culturing of mucoraceous fungi, and opacification of the left maxillary sinus observed by MRI dictated the need for surgical cleaning of the paranasal sinuses. All the surgical specimens were sent to laboratories for mycological and histopathological studies. Direct microscopy of KOH preparations and tissue sections of the left maxillary sinus showed broad hyphae, typically coenocytic, characteristic of mucoraceous fungi. No evidence of osseous tissue invasion or eosinophils was observed.The results of histopathological and mycological examinations of the surgical specimens from ethmoid, sphenoid, and frontal sinuses were negative for fungi.The same fungus was isolated from the seromucous material and from the maxillary sinus. The fungus was isolated as a single microorganism from both samples.In addition to the surgical cleaning, the patient was treated with amphotericin B administered intravenously (1 mg/kg of body weight/day) and by irrigation of the maxillary antrum (5 mg/day), both for 42 days.The patient was monitored bimonthly by MRI for 6 months after surgery. Although persistence of the opacity in the left maxillary sinus was observed, monthly clinical studies to date have shown an asymptomatic patient with negative mycological study results.Mycological findings. The spontaneously expelled seromucous material and a portion of each tissue biopsy from the paranasal sinuses were inoculated on Sabouraud glucose agar with 5% (vol/vol) blood and Sabouraud glucose-honey agar supplemented with chloramphenicol and 0.5% (wt/vol) yeast extract and incubated at 28 and 37°C.In both samples, several cottony, white colonies were evident after 48 h of incubation, and microscopic examination showed that they consisted of coenocytic, branched hyphae of variable widths (10 to 25 m), characteristic of mucorace...
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