Acremonium kiliense infection in a child with chronic granulomatous disease

Pastorino, Antônio Carlos; Menezes, Ulissis Pádua de; Marques, Heloísa Helena de Souza; Vallada, Marcelo Genofre; Cappellozi, V. L.; Carnide, E.M.G.; Jacob, Cristina Miuki Abe

doi:10.1590/s1413-86702005000600014

Cited by 19 publications

(23 citation statements)

References 22 publications

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“…Five of these cases were reported from the United States (4,8), four each were reported from Brazil (15,16,20,29) and India (6,11,37), two each were reported from Argentina (2, 26) and France (17,19), and one was reported from Hungary (35). Only three of these cases occurred in immunocompromised patients, and the fungus was isolated from heart and brain tissue (15), blood (17), and lung tissue (29). Of these patients, one died (15) and two survived the infection (17,29).…”

Section: Case Reportmentioning

confidence: 99%

“…Only three of these cases occurred in immunocompromised patients, and the fungus was isolated from heart and brain tissue (15), blood (17), and lung tissue (29). Of these patients, one died (15) and two survived the infection (17,29). In the remaining 15 patients, who were apparently immunocompetent, the infections were localized and were treated with antifungal agents with or without surgical debridement of the infected tissue (Table 2).…”

Section: Case Reportmentioning

confidence: 99%

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Acremonium kiliense: Reappraisal of Its Clinical Significance

et al. 2011

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A case of Acremonium kiliense peritonitis is described. Diagnosis was established by repeated isolation of the fungus from peritoneal dialysate and by its identification on the basis of morphological characteristics and sequencing of internal transcribed spacer (ITS) regions of ribosomal DNA (rDNA). This report and available literature suggest that A. kiliense may have a greater clinical significance than hitherto recognized. CASE REPORTA 75-year-old Jordanian man with a long history of diabetes mellitus and hypertension developed end-stage kidney disease requiring continuous ambulatory peritoneal dialysis (CAPD). His course of CAPD was largely uneventful except for a single episode of bacterial peritonitis, for which he was hospitalized and treated with parenteral antibiotics, with an excellent response. In January 2010, he became febrile, with clinical evidence of peritonitis, and was admitted to the hospital. The peritoneal fluid was turbid, with a white blood cell (WBC) count of 2.1 ϫ 10 9 /liter. On initial microscopic examination, the presence of fungal elements in the peritoneal dialysate was missed. The peritoneal fluid sample was inoculated into aerobic Bactec blood culture bottles, which yielded a growth after 59 h of incubation. The Gram-stained smear from blood culture bottles showed branched hyphal elements. On Sabouraud dextrose agar (SDA; Oxoid Ltd., Basingstoke, England), the specimen yielded slimy colonies with a pinkish appearance ( Fig. 1). Microscopic examination of the primary culture (isolate Kw441-2010) showed hyaline hyphae, with scanty sporulation. A provisional identification of Acremonium/Fusarium species was made, and the growth was subcultured on Sabouraud dextrose agar and oatmeal agar (OMA; oatmeal [30 g], agar [20 g], distilled water [1 liter]) for further identification and antifungal susceptibility testing. Subsequent cultures of the peritoneal fluid yielded the same fungus on three occasions. A serum sample was obtained for the detection of galactomannan (Platelia Aspergillus enzyme immunoassay [EIA] kit; BioRad, Marnes-la-Coquette, France) and (1-3)-␤-D-glucan (Fungitell; Associates of Cape Cod); the latter test was positive (253 pg/ml). An Etest performed on RPMI 1640 medium supplemented with 2% glucose revealed that the isolate was resistant to amphotericin B and caspofungin but susceptible to voriconazole and posaconazole, with MIC values of Ͼ32 g/ml, Ͼ32 g/ml, 0.064 g/ml, and 0.75 g/ml, respectively. The patient was started on voriconazole, with a loading dose of 400 mg, followed by a maintenance dose of 200 mg, given every 12 h via the oral route. Although the patient showed clinical improvement after 2 weeks of voriconazole therapy, the peritoneal dialysate remained turbid (WBC counts, 2.0 ϫ 10 9 / liter). Abdominal ultrasound examination did not reveal any evidence of intraperitoneal adhesions or organ invasion. Since the response to treatment was not adequate, the Tenckhoff catheter was removed and the patient was temporarily switched to hemodialysis. After 1 week of a...

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Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Acremonium kiliense: Reappraisal of Its Clinical Significance

et al. 2011

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“…Some species are contaminants and parasitize live fungi and algae (Bott & Rogenmuser 1980). Acremonium kiliense has been recognized as a human pathogen mainly in imunocompromised patients and in other animals such as dogs (Mendoza et al1985, Simon et al 1991, Fridkin 1996, Pastorino et al 2005. It also has enzymatic properties on account of the production of Cephalosporium acremonium with proteolytic activity (Heyningen et al 1971).…”

Section: Acremonium Kiliense (Fig 1a)mentioning

confidence: 99%

Filamentous fungi associated with mosquito larvae (Diptera: Culicidae) in municipalities of the Brazilian Amazon

Pereira¹,

Sarquis²,

Ferreira-Keppler³

et al. 2009

Neotrop. entomol.

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“…have been reported to cause pulmonary infection in children with CGD on two previous occasions [4, 5]. To our knowledge, this is the first instance where an adult with CGD has been infected with acremonium or where the skin has been the main site of infection.…”

Section: Discussionmentioning

confidence: 75%

Mycetoma Caused by Acremonium Species in a Patient with Chronic Granulomatous Disease

Antrobus

Wong

Jones

et al. 2016

Case Reports in Immunology

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Patients with chronic granulomatous disease are predisposed to fungal infections and are therefore routinely prescribed antifungal prophylaxis. We report a case where acremonium was responsible for causing a cutaneous infection (mycetoma) despite antifungal prophylaxis. Treatment with voriconazole was initiated and the infection gradually resolved. This case highlights the need for careful clinical follow-up and thorough investigation of patients who have a neutrophil immunodeficiency.

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Acremonium kiliense infection in a child with chronic granulomatous disease

Cited by 19 publications

References 22 publications

Acremonium kiliense: Reappraisal of Its Clinical Significance

Acremonium kiliense: Reappraisal of Its Clinical Significance

Filamentous fungi associated with mosquito larvae (Diptera: Culicidae) in municipalities of the Brazilian Amazon

Mycetoma Caused by Acremonium Species in a Patient with Chronic Granulomatous Disease

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