Meningoencephalitis caused by a zygomycete fungus (Basidiobolus) associated with septic shock in an immunocompetent patient: 1-year follow-up after treatment

Auxiliadora‐Martins, Maria; Alkmim-Teixeira, Gil Cezar; Machado-Viana, Jaciara; Nicolini, Edson Antônio; Martins‐Filho, Olindo Assis; Bellissimo-Rodrigues, Fernando; Carlotti, Carlos Gilberto; Basile-Filho, Aníbal

doi:10.1590/s0100-879x2010007500067

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…Invasive zygomycosis is associated with angioinvasive disease, which can lead to thrombosis and infarction [5]. Other types of infections that have been described are meningoencephalitis, necrotizing fasciitis and osteomyelitis [6,7].…”

Section: Resultsmentioning

confidence: 99%

5 Year-old Boy with a Hearth Murmur and Fever

Dikkers

Ach²,

Lequin

2016

J Pulm Respir Med

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Section: Resultsmentioning

confidence: 99%

5 Year-old Boy with a Hearth Murmur and Fever

Dikkers

Ach²,

Lequin

2016

J Pulm Respir Med

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“…Among filamentous fungi, A. fumigatus is the most common cause of invasive fungal infections in clinical settings, so most of the available fungal detection methods target this organism and often rely on culture, antigen, and/or radiological findings (16)(17)(18). Although other filamentous fungi have been documented as causes of human meningitis and/or encephalitis, most of these infections have been diagnosed postmortem (19,20). Furthermore, the sensitivity of fungus culture for detection of molds in CSF is very low (13,18).…”

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confidence: 99%

Detection of Fungal DNA in Human Body Fluids and Tissues during a Multistate Outbreak of Fungal Meningitis and Other Infections

et al. 2013

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Exserohilum rostratum was the major cause of an outbreak of fungal infections linked to injections of contaminated methylprednisolone acetate. Because almost 14,000 persons were exposed to product that was possibly contaminated with multiple fungal pathogens, there was unprecedented need for a rapid throughput diagnostic test that could detect both E. rostratum and other unusual agents of fungal infection. Here we report development of a novel PCR test that allowed for rapid and specific detection of fungal DNA in cerebrospinal fluid (CSF), other body fluids and tissues of infected individuals. The test relied on direct purification of free-circulating fungal DNA from fluids and subsequent PCR amplification and sequencing. Using this method, we detected Exserohilum rostratum DNA in 123 samples from 114 case-patients (28% of 413 case-patients for whom 627 samples were available), and Cladosporium DNA in one sample from one case-patient. PCR with novel Exserohilum-specific ITS-2 region primers detected 25 case-patients with samples that were negative using broad-range ITS primers. Compared to fungal culture, this molecular test was more sensitive: of 139 case-patients with an identical specimen tested by culture and PCR, E. rostratum was recovered in culture from 19 (14%), but detected by PCR in 41 (29%), showing a diagnostic sensitivity of 29% for PCR compared to 14% for culture in this patient group. The ability to rapidly confirm the etiologic role of E. rostratum in these infections provided an important contribution in the public health response to this outbreak. In late September 2012, the Centers for Disease Control and Prevention (CDC) began to investigate an outbreak of fungal meningitis associated with epidural injections of contaminated methylprednisolone acetate solution purchased from a single compounding pharmacy (1-5). By 15 January 2013, 678 cases of fungal infections, including meningitis, spinal, paraspinal, or peripheral joint infections, had been reported from 19 states, and 44 people had died. Although Aspergillus fumigatus was isolated from the index patient (1), and several fungal species were identified in patients during the outbreak, the vast majority of laboratory-confirmed infections were caused by Exserohilum rostratum, which was detected in cerebrospinal fluid (CSF) and tissues of patients (3, 6).E. rostratum (teleomorph Setophaeria rostrata) is a dematiaceous (brown-black) filamentous fungus, which is common in the environment and occasionally causes opportunistic infections in humans (7-9). In healthy individuals, exposure to E. rostratum can cause allergic sinusitis or cutaneous and subcutaneous infections (7, 10, 11). Invasive fungal infections due to E. rostratum are rare and limited to persons with severely impaired immune systems (7, 10, 12). To our knowledge, no cases of fungal meningitis or encephalitis due to this fungus had been described prior to this outbreak. In addition, no genome or animal models had been developed to study E. rostratum, which also complicated the deve...

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Epidemiology of Invasive Fungal Infections in Latin America

Sifuentes–Osornio

Corzo-León

Ponce-de-León

2012

Curr Fungal Infect Rep

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The pathogenic role of invasive fungal infections (IFIs) has increased during the past two decades in Latin America and worldwide, and the number of patients at risk has risen dramatically. Working habits and leisure activities have also been a focus of attention by public health officials, as endemic mycoses have provoked a number of outbreaks. An extensive search of medical literature from Latin America suggests that the incidence of IFIs from both endemic and opportunistic fungi has increased. The increase in endemic mycoses is probably related to population changes (migration, tourism, and increased population growth), whereas the increase in opportunistic mycoses may be associated with the greater number of people at risk. In both cases, the early and appropriate use of diagnostic procedures has improved diagnosis and outcome.

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Meningoencephalitis caused by a zygomycete fungus (Basidiobolus) associated with septic shock in an immunocompetent patient: 1-year follow-up after treatment

Cited by 4 publications

References 20 publications

5 Year-old Boy with a Hearth Murmur and Fever

5 Year-old Boy with a Hearth Murmur and Fever

Detection of Fungal DNA in Human Body Fluids and Tissues during a Multistate Outbreak of Fungal Meningitis and Other Infections

Epidemiology of Invasive Fungal Infections in Latin America

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