Alternaria infectoria brain abscess in a child with chronic granulomatous disease

Hipolito, E.; Faria, Emília; Alves, Ana Florinda; Hoog, G.S. de; Anjos, Jorge; Gonçalves, Teresa; Morais, Paula V.; Estevão, H.

doi:10.1007/s10096-008-0623-2

Cited by 28 publications

(20 citation statements)

References 19 publications

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“…Mortality was Ͼ70%. Since that review in 2004, over 50 cases have been reported, with C. bantiana remaining the most frequently seen isolate (131,4,17,16,22,31,40,70,78,93,121,139,170,189,243,244,268,272,276,328,332,341,363,380,399,420,433,448,450,467,476,545,575,636,657,696,700,721,731,733,754,759). A new species, Fonsecaea monophora, has been reported since that time and appears to have a predilection for causing CNS disease, in contrast to its related species, F. pedrosoi (420,721,733).…”

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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“…Another A. infectoria clinical isolate was used for determination of the polyketide synthase nucleotide sequence. The latter isolate was previously obtained by us (30) and is deposited in the CBS collection as strain CBS 122351. A. alternata was kindly provided by R. Freitas and R. M. B. Ferreira (Instituto Superior de Agronomia, Universidade de Lisboa, Lisbon, Portugal).…”

Section: Organisms and Mediamentioning

confidence: 99%

Activation of Melanin Synthesis in Alternaria infectoria by Antifungal Drugs

Fernandes

Prados-Rosales

Silva

et al. 2016

Antimicrob Agents Chemother

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The importance of Alternaria species fungi to human health ranges from their role as etiological agents of serious infections with poor prognoses in immunosuppressed individuals to their association with respiratory allergic diseases. The present work focuses on Alternaria infectoria, which was used as a model organism of the genus, and was designed to unravel melanin production in response to antifungals. After we characterized the pigment produced by A. infectoria, we studied the dynamics of 1,8-dihydroxynaphthalene (DHN)-melanin production during growth, the degree of melanization in response to antifungals, and how melanization affected susceptibility to several classes of therapeutic drugs. We demonstrate that A. infectoria increased melanin deposition in cell walls in response to nikkomycin Z, caspofungin, and itraconazole but not in response to fluconazole or amphotericin B. These results indicate that A. infectoria activates DHN-melanin synthesis in response to certain antifungal drugs, possibly as a protective mechanism against these drugs. Inhibition of DHN-melanin synthesis by pyroquilon resulted in a lower minimum effective concentration (MEC) of caspofungin and enhanced morphological changes (increased hyphal balloon size), characterized by thinner and less organized A. infectoria cell walls. In summary, A. infectoria synthesizes melanin in response to certain antifungal drugs, and its susceptibility is influenced by melanization, suggesting the therapeutic potential of drug combinations that affect melanin synthesis.

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“…Clinical manifestations of the saprobic Alternaria species usually are cutaneous or subcutaneous lesions after trauma (Halaby et al 2001;Lo Cascio et al 2004) in patients under prolonged corticosteroid treatment. Other clinical entities, such as cerebral infections, sinusitis, keratitis, and allergic bronchopulmonary mycosis, are very rare (Hipolito et al 2009;Chowdhary et al 2012Chowdhary et al , 2014a. The most common etiologic agents are Alternaria alternata and Alternaria infectoria and, occasionally, Alternaria chlamydospora.…”

Section: Black Molds and Yeasts Pathogenic To Humansmentioning

confidence: 99%