Allergic fungal sinusitis in the southeastern USA: involvement of a new agent<i>Epicoccum nigrum</i>Ehrenb. ex Schlecht. 1824

Noble, J A; Crow, Sidney A.; Ahearn, Donald G.; Kühn, Frederick A.

doi:10.1080/02681219780001501

Cited by 54 publications

(33 citation statements)

References 18 publications

(12 reference statements)

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“…The most common species isolated are Alternaria, Bipolaris, and Curvularia, though other rare fungi (Epicoccum and Nodulisporium) have also been reported (155,544,673). However, fungi are frequently isolated from normal individuals as well (668).…”

Section: Phaeohyphomycosismentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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SUMMARY Melanized or dematiaceous fungi are associated with a wide variety of infectious syndromes. Many are soil organisms and are generally distributed worldwide, though certain species appear to have restricted geographic ranges. Though they are uncommon causes of disease, melanized fungi have been increasingly recognized as important pathogens, with most reports occurring in the past 20 years. The spectrum of diseases with which they are associated has also broadened and includes allergic disease, superficial and deep local infections, pneumonia, brain abscess, and disseminated infection. For some infections in immunocompetent individuals, such as allergic fungal sinusitis and brain abscess, they are among the most common etiologic fungi. Melanin is a likely virulence factor for these fungi. Diagnosis relies on careful microscopic and pathological examination, as well as clinical assessment of the patient, as these fungi are often considered contaminants. Therapy varies depending upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Triazoles such as voriconazole, posaconazole, and itraconazole have the most consistent in vitro activity. Further studies are needed to better understand the pathogenesis and optimal treatment of these uncommon infections.

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Section: Phaeohyphomycosismentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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“…The larger particles would deposit mainly in the naso-oro-pharyngolaryngeal region of the respiratory tract (Yeh et al, 1996). Indeed, it has been documented that A. fumigatus causes allergic bronchopulmonary aspergillosis (Greenberger, 2002) whereas Alternaria and Epicoccum cause allergic fungal sinusitis and are found in nasal sinuses of hypersensitive patients (Noble et al, 1997).…”

Section: Abundance Of Allergenic and Pathogenic Fungimentioning

confidence: 99%

Particle-size distributions and seasonal diversity of allergenic and pathogenic fungi in outdoor air

et al. 2012

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Fungi are ubiquitous in outdoor air, and their concentration, aerodynamic diameters and taxonomic composition have potentially important implications for human health. Although exposure to fungal allergens is considered a strong risk factor for asthma prevalence and severity, limitations in tracking fungal diversity in air have thus far prevented a clear understanding of their human pathogenic properties. This study used a cascade impactor for sampling, and quantitative real-time PCR plus 454 pyrosequencing for analysis to investigate seasonal, size-resolved fungal communities in outdoor air in an urban setting in the northeastern United States. From the 20 libraries produced with an average of ∼800 internal transcribed spacer (ITS) sequences (total 15 326 reads), 12 864 and 11 280 sequences were determined to the genus and species levels, respectively, and 558 different genera and 1172 different species were identified, including allergens and infectious pathogens. These analyses revealed strong relationships between fungal aerodynamic diameters and features of taxonomic compositions. The relative abundance of airborne allergenic fungi ranged from 2.8% to 10.7% of total airborne fungal taxa, peaked in the fall, and increased with increasing aerodynamic diameter. Fungi that can cause invasive fungal infections peaked in the spring, comprised 0.1–1.6% of fungal taxa and typically increased in relative abundance with decreasing aerodynamic diameter. Atmospheric fungal ecology is a strong function of aerodynamic diameter, whereby through physical processes, the size influences the diversity of airborne fungi that deposit in human airways and the efficiencies with which specific groups of fungi partition from outdoor air to indoor environments.

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“…Bipolaris spicifera appears frequently in medical literature as a cause of diseases in humans and animals. Besides cutaneous and subcutaneous phaeohyphomycoses (15,31), a meningitis (12), fungemia in children infected with human immunodeficiency virus (32), disseminated infection (9), a mycotic keratitis (8), a fatal fungal endarteritis (21), and disseminated infection in a neonate (17), most of the cases where Bipolaris spicifera is involved are pertaining to the nasal sinuses (6,14,16,20,23,25,26,27,28,29,30). Interestingly, many of these cases were encountered in areas where a hot climate is predominant (Texas, South Carolina, Arizona, and Georgia in the United States; Brisbane, Australia; Pakistan; and India).…”

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confidence: 99%

Bipolaris spiciferaCauses Fungus Balls of the Sinuses and Triggers Polypoid Chronic Rhinosinusitis in an Immunocompetent Patient

et al. 2003

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We report the rare case of a 19-year-old immunocompetent male suffering both from fungus balls of the sinuses and from chronic rhinosinusitis with massive polyposis. Endoscopic sinus surgery revealed grayish brown necrotic masses embedded in viscous eosinophilic mucus. Inoculated onto petri dishes, these masses as well as the mucus grew a dark pigmented fungus, which was identified as Bipolaris spicifera. CASE REPORTA 19-year-old immunocompetent (human immunodeficiency virus negative, no evidence for malignancy) man was referred to our clinic because of restricted nasal breathing for 1 year and total nasal obstruction for more than 4 months. Computed tomography scan revealed massive sinusitis, with significant decalcification and destruction of the bone at skull base. Polyps and fungal masses had elevated the dura and extended far intracranially, especially in the frontal recess region and the roof of the anterior ethmoid. The dura appeared to be pushed against the brain for more than 1 cm on both sides (Fig. 1). On magnetic resonance imaging, however, there appeared to be no infiltration or penetration of the dura. Endoscopic examination showed a total obstruction of both nostrils with glassy polyps. Immunological examination of the patient's blood showed a highly elevated level of total immunoglobulin E (IgE) (4,446 kU per liter (kUL Ϫ1 ); normal value, Ͻ100 kUL Ϫ1 ). Specific IgE tests (UniCAP; Pharmacia, Uppsala, Sweden) yielded classes 3 and 4 for all fungal allergens tested ( ). Clinical chemistry showed no abnormalities in electrolytes, substrates, enzymes, and proteins, blood coagulation parameters were also in the normal range. The differential white blood cell count indicated significant eosinophilia (20% of leukocytes, 1 billion per liter); the basophil levels were also elevated slightly (1.6%).Endoscopic sinus surgery of both sides was performed by using VTI-Navigation (Visualization Technology, Inc./GE Medical Systems, Lawrence, Mass.). On the left side, the patient presented with a massive polyposis, with polyps protruding as far as the nasal vestibulum. Mucus masses were aspirated first and preserved for mycological examination. Then, in a stepwise fashion, the anteriormost polyps were removed until a huge mucocele of the concha bullosa of the middle turbinate was identified. This mucocele reached almost to the nasal vestibule and filled most of the nasal lumen. When opened there were massive polyps with glue-like mucus and fungal masses inside the concha. Then, in a stepwise fashion, preparation was taken further posteriorly and up, until in the posterior ethmoid skull base could be identified. Laterally, the polyps and fungal masses had protruded significantly (8 to 10 mm) toward the orbit; the bony border was missing partially. Only with navigational support was it possible to avoid all of the areas of hazard in this distorted anatomy. Removal of the glue-like inspissated material was extremely difficult and time-consuming. The sphenoid sinus was then identified and opened; it, too, was filled ...

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Allergic fungal sinusitis in the southeastern USA: involvement of a new agentEpicoccum nigrumEhrenb. ex Schlecht. 1824

Cited by 54 publications

References 18 publications

Melanized Fungi in Human Disease

Melanized Fungi in Human Disease

Particle-size distributions and seasonal diversity of allergenic and pathogenic fungi in outdoor air

Bipolaris spiciferaCauses Fungus Balls of the Sinuses and Triggers Polypoid Chronic Rhinosinusitis in an Immunocompetent Patient

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