Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum

Morais, Orlando Oliveira de; Porto, Cláudia Sellitto; Coutinho, Anglya Samara Silva Leite; Reis, Carmélia Matos Santiago; Teixeira, Marcus de Melo; Gomes, Ciro Martins

doi:10.1590/s1413-86702011000300019

Cited by 3 publications

(6 citation statements)

References 14 publications

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“…Moreover, it is also an opportunistic infectious fungus, causing an infective abscess in various organs, systemic disseminated infection and fungal sepsis [19]. Morais OOD reported a case of a patient with infection of the lymphatic system by A. pullulans [20]. The latest report on A. plullans infection is a case of co-infection of AIDS patients in 2018 [21].…”

Section: Discussionmentioning

confidence: 99%

Molecular diagnosis and source tracing of an infection of Aureobasidium pullulans

Liu¹,

Shi

et al. 2019

J Infect Dev Ctries

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Aureobasidium pullulans (A. pullulans) is a dematiaceous, yeast-like fungus that is ubiquitous in nature, which can colonize the human hair and skin. A. pullulans has been clinically implicated to cause skin and soft tissue infections, meningitis, splenic abscesses, and peritonitis. Herein, molecular diagnostic of internal transcribed spacer (ITS) sequencing was used to investigate a suspected case of A. pullulans infection, and the infection source had been traced. A 27-year-old female case was suspected of kala-azar due to the recurrent fever. Bone marrow specimens were analyzed. The samples were negative for Leishmania, Penicillium marneffei and Histoplasma capsulatum. DNA was extracted from the bone marrow specimens, and the 583-bp sequence was amplified with the fungal ITS universal primers. The sequence was compared by Blast query to be identified as A. pullulans. A strain of A. pullulans was also isolated from the kitchen of the patient’s living room. Culture characteristics were the same as the human pathogens of A. pullulans, and the ITS sequence was identical to the bone marrow ITS amplification. In conclusion, a deep infection caused by A. pullulans is rare, often occurring in the indwelling catheter, which may cause peritonitis and other symptoms. ITS sequencing of fungi can be used as a diagnostic reference. As A. pullulans is a common fungus in environment, amplification of ITS sequence of A. pullulans in the aseptic body fluid would be necessary to make a comprehensive diagnosis based on the clinical symptoms and signs.

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Section: Discussionmentioning

confidence: 99%

Molecular diagnosis and source tracing of an infection of Aureobasidium pullulans

Liu¹,

Shi

et al. 2019

J Infect Dev Ctries

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“…Culture and microscopic examination remain the definitive methods to identify these fungi. Skin infections can be seen in immunocompetent hosts with soil‐contaminated wounds or with the introduction of foreign bodies into the skin, but it is now known to have been documented as causing cutaneous infection to invasive and potentially life‐threatening infections in humans . Among immunocompromised patients, organ transplant recipients may be at particularly higher risk.…”

Section: Discussionmentioning

confidence: 99%

“…Disseminated systemic infections by A. pullulans are very rare and occur in patients on broad‐spectrum antibiotics, invasive devices such as central venous catheters, and in immunocompromised patients . In an extensive search of the literature, we could find only three pediatric patients with A. pullulans fungemia .…”

Section: Discussionmentioning

confidence: 99%

“…These multiple roles may explain the pathogenic potential of dematiaceous fungi, even in immunocompetent hosts . Trauma, medical procedures such as catheter insertion and surgery, and immunosuppressive conditions such as cancer or organ transplantation are the most common risk factors …”

Section: Discussionmentioning

confidence: 99%

“…In the literature, the association between A. pullulans spp. and human infectious diseases is described as being mainly associated to skin, soft tissue infections, fungemia (septicemia), systemic infections, and abscesses in different viscera …”

Section: Introductionmentioning

confidence: 99%

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Disseminated fungal infection by Aureobasidium pullulans in a renal transplant recipient

Nalçacıoğlu

Yakupoğlu

Genç

et al. 2018

Pediatric Transplantation

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Renal transplant recipients are on long-term potent immunosuppressive therapy, which makes them highly vulnerable to opportunistic fungal infections. Dematiaceous, or dark-pigmented saprophytic fungi, are being increasingly seen as opportunistic pathogens of mycoses in immunosuppressed patients. One of these is Aureobasidium pullulans, which is a black yeast-like dematiaceous fungus found ubiquitously in the environment that can cause various opportunistic human infections. Most infections occur by traumatic inoculation, such as keratitis and cutaneous lesions; disseminated mycoses are very rare and occur only in severely immunocompromised patients. We report a case of disseminated fungal infection due to A. pullulans in a pediatric patient who underwent renal transplant. The use of voriconazole and vacuum-assisted closure along with surgical drainage most likely contributed to the patient's positive outcome.

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ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi

Chowdhary

Meis

Guarro

et al. 2014

Clinical Microbiology and Infection

276

246

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The aetiological agents of many invasive fungal infections are saprobes and opportunistic pathogens. Some of these fungi are darkly pigmented due to melanin production and traditionally have been named 'dematiaceous'. The melanized fungi cause a wide array of clinical syndromes ranging from superficial to deep-seated infections. Diagnosis relies on histopathological examination of clinical specimens and on examination of cultures. Sequencing is recommended for accurate species identification, especially for unusual or newly described pathogens. In cases of mycetoma and chromoblastomycosis, pathognomonic histological findings are useful and the Fontana-Masson stain, specific for melanin, usually confirms the diagnosis. There are no standardized therapies but voriconazole, posaconazole and itraconazole demonstrate the most consistent in vitro activity against this group of fungi. Oral itraconazole has been considered the drug of choice, given the extensive clinical experience with this drug. However, voriconazole may presumably be superior for central nervous system infections because of its ability to achieve good levels in the cerebrospinal fluid. Posaconazole is a well-tolerated alternative drug, backed by less clinical experience but with excellent salvage treatment results after failure of other antifungals. Amphotericin B has been useful as alternative therapy in some cases. Combination antifungal therapy is recommended for cerebral abscesses when surgery is not possible and for disseminated infections in immunocompromised patients.

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Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum

Cited by 3 publications

References 14 publications

Molecular diagnosis and source tracing of an infection of Aureobasidium pullulans

Molecular diagnosis and source tracing of an infection of Aureobasidium pullulans

Disseminated fungal infection by Aureobasidium pullulans in a renal transplant recipient

ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi

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