A pseudoepidemic of<i>Sporothrix cyanescens</i>pneumonia occurring during renovation of a bronchoscopy suite

Jackson, La Scienya M.; Klotz, Stephen A.; Normand, R.

doi:10.1080/02681219080000571

Cited by 15 publications

(8 citation statements)

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“…However, none of the above studies provided unequivocal clinical evidence of infection. In addition, Jackson et al reported a pseudo-epidemic of Q. cyanescens pneumonia in a US hospital introduced by contamination of bronchoscopy suites [13] , which suggests that the species may be an environmental contaminant in human patients.…”

Section: Discussionmentioning

confidence: 99%

“…Q. cyanescens is one of the rare clinical basidiomycetous pathogens. Most of Q. cyanescens isolated from the humans were reported in the 1990s, including pseudoepidemic nosocomial pneumonia cases reported in a US hospital [13] , a possible pulmonary case in a heart transplant patient [14] and potential fungemia in lymphoma patients [11] . However, none of these published human-related cases deposited convincing molecular data.…”

Section: Introductionmentioning

confidence: 99%

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A Rare Fungal Species, Quambalaria cyanescens, Isolated from a Patient after Augmentation Mammoplasty – Environmental Contaminant or Pathogen?

et al. 2014

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Some emerging but less common human fungal pathogens are known environmental species and could be of low virulence. Meanwhile, some species have natural antifungal drug resistance, which may pose significant clinical diagnosis and treatment challenges. Implant breast augmentation is one of the most frequently performed surgical procedures in China, and fungal infection of breast implants is considered rare. Here we report the isolation of a rare human fungal species, Quambalaria cyanescens, from a female patient in China. The patient had undergone bilateral augmentation mammoplasty 11 years ago and was admitted to Peking Union Medical College Hospital on 15 September 2011 with primary diagnosis of breast infection. She underwent surgery to remove the implant and fully recovered thereafter. During surgery, implants and surrounding tissues were removed and sent for histopathology and microbiology examination. Our careful review showed that there was no solid histopathologic evidence of infection apart from inflammation. However, a fungal strain, which was initially misidentified as “Candida tropicalis” because of the similar appearance on CHROMagar Candida, was recovered. The organism was later on re-identified as Q. cyanescens, based on sequencing of the rDNA internal transcribed spacer region rather than the D1/D2 domain of 26S rDNA. It exhibited high MICs to 5-flucytosine and all echinocandins, but appeared more susceptible to amphotericin B and azoles tested. The possible pathogenic role of Q. cyanescens in breast implants is discussed in this case, and the increased potential for misidentification of the isolate is a cause for concern as it may lead to inappropriate antifungal treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Rare Fungal Species, Quambalaria cyanescens, Isolated from a Patient after Augmentation Mammoplasty – Environmental Contaminant or Pathogen?

et al. 2014

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“…Q . cyanescens is a rare human basidiomycetous pathogen [ 4 , 14 , 15 ]. The accumulation of data from reported clinical cases suggest that this species is potentially an opportunistic pathogen isolated primarily from immunocompromised or debilitated individuals [ 4 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Identification and Characterization of a Rare Fungus, Quambalaria cyanescens, Isolated from the Peritoneal Fluid of a Patient after Nocturnal Intermittent Peritoneal Dialysis

et al. 2015

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Peritonitis is the leading complication of peritoneal dialysis, which is primarily caused by bacteria rather than fungi. Peritonitis is responsible for approximately 18% of the infection-related mortality in peritoneal dialysis patients. In this paper, we report the isolation of a rare fungus, Quambalaria cyanescens, from the peritoneal fluid of a man after he switched from continuous ambulatory peritoneal dialysis to nocturnal intermittent peritoneal dialysis. Based on the morphological examination and multigene phylogeny, the clinical isolate was confirmed as Q. cyanescens. This pathogen exhibited low sensitivity to all tested echinocandins and 5-flucytosine. Interestingly, morphological characterization revealed that Q. cyanescens UM 1095 produced different pigments at low temperatures (25°C and 30°C) on various culture media. It is important to monitor the emergence of this rare fungus as a potential human pathogen in the tropics. This study provides insight into Q. cyanescens UM 1095 phenotype profiles using a Biolog phenotypic microarray (PM). Of the 760 nutrient sources tested, Q. cyanescens UM 1095 utilized 42 compounds, and the fungus can adapt to a broad range of osmotic and acidic environments. To our knowledge, this is the first report of the isolation of Q. cyanescens from peritoneal fluid, revealing this rare fungus as a potential human pathogen that may be misidentified using conventional methods. The detailed morphological, molecular and phenotypic characterization of Q. cyanescens UM 1095 provides the basis for future studies on its biology, lifestyle, and potential pathogenicity.

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“…Cure rates with itraconazole are over 95%. 28 Fluconazole (initially commenced in Case 3) is ineffective. Alternative agents include terbinafine and amphotericin B, which also have excellent activity against the organism.…”

Section: -28mentioning

confidence: 99%

“…26 Sporothrix cyanescens features in just two other human reports as a potential pathogen 27 or an environmental contaminant appearing in bronchial washings. 28 Quambalaria species cause pathology such as canker and shoot blight in Australian native trees of the Eucalyptus and Corymbia genera (red flowering gums) 32 different trees from those with which Cryptococcus gattii is associated. 33 We hypothesise that Q. cyanescens was inoculated at the same time as S. schenckii, given its similar ecological niche, and colonized the wound.…”

Section: -28mentioning

confidence: 99%

Sporotrichosis from the Northern Territory of Australia

Subedi¹,

Kidd²,

Baird³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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A pseudoepidemic ofSporothrix cyanescenspneumonia occurring during renovation of a bronchoscopy suite

Cited by 15 publications

References 5 publications

A Rare Fungal Species, Quambalaria cyanescens, Isolated from a Patient after Augmentation Mammoplasty – Environmental Contaminant or Pathogen?

A Rare Fungal Species, Quambalaria cyanescens, Isolated from a Patient after Augmentation Mammoplasty – Environmental Contaminant or Pathogen?

Identification and Characterization of a Rare Fungus, Quambalaria cyanescens, Isolated from the Peritoneal Fluid of a Patient after Nocturnal Intermittent Peritoneal Dialysis

Sporotrichosis from the Northern Territory of Australia

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