Candida lusitaniae and Chronic Granulomatous Disease

Estrada, Benjamin; Mancao, M.; Polski, Jacek M.; Figarola, Maria S.

doi:10.1097/01.inf.0000227802.32163.a4

Cited by 13 publications

(11 citation statements)

References 4 publications

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“…A typical finding in this case is the presence of a necrotizing granulomatous lesion with possible microabscess formation and yeast forms or pseudohyphae [45,89].…”

Section: Candida Infections In Cgd Patientsmentioning

confidence: 95%

“…Lymphadenitis has been reported to involve the cervical but also intra-abdominal (retroperitoneal) lymph nodes [45]. Young infants seem to be at risk for disseminated infection [89].…”

Section: Candida Infections In Cgd Patientsmentioning

confidence: 99%

“…There are no data on the relative frequency of different Candida species isolated from CGD patients. Candida albicans, Candida glabrata, Candida lusitaniae and Candida dubliniensis have been associated with invasive disease according to individual case reports [32,41,45,49,89,97,106,110,120].…”

Section: Candida Infections In Cgd Patientsmentioning

confidence: 99%

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Fungal infections in primary immunodeficiencies

2007

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Patients with phagocytic, cellular, combined and other primary immunodeficiencies exhibit immune deficits that confer increased susceptibility to fungal infections. A number of yeasts and moulds, most commonly Candida and Aspergillus but also Cryptococcus, Histoplasma, Paecilomyces, Scedosporium, Trichosporon, Penicillium and other, rarely isolated, fungal organisms, have been variably implicated in causing disease in patients with chronic granulomatous disease, severe combined immunodeficiency, chronic mucocutaneous candidiasis, hyper-IgE syndrome, myeloperoxidase deficiency, leukocyte adhesion deficiency, defects in the interferon-gamma/interleukin-12 axis, DiGeorge syndrome, X-linked hyper-IgM syndrome, Wiskott-Aldrich syndrome and common variable immunodeficiency. Differences in the spectrum of fungal pathogens as well as in the incidence and clinical presentation of the infections may be observed among patients, depending upon different immune disorders. Fungal infections in these individuals may occasionally be the presenting clinical manifestation of a primary immunodeficiency and can cause significant morbidity and potentially fatal outcome if misdiagnosed or mistreated. A high degree of suspicion is needed and establishment of diagnosis should actively be pursued using appropriate imaging, mycological and histological studies. A number of antifungal agents introduced over the last fifteen years, such as the lipid formulations of amphotericin B, the second-generation triazoles, and the echinocandins, increase the options for medical management of these infections. Surgery may also be needed in some cases, while the role of adjunctive immunotherapy has not been systematically evaluated. The low incidence of primary immunodeficiencies in the general population complicates single-center prospective or retrospective clinical studies aiming to address diagnostic or therapeutic issues pertaining to fungal infections in these patients.

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“…A typical finding in this case is the presence of a necrotizing granulomatous lesion with possible microabscess formation and yeast forms or pseudohyphae [45,89].…”

Section: Candida Infections In Cgd Patientsmentioning

confidence: 95%

“…Lymphadenitis has been reported to involve the cervical but also intra-abdominal (retroperitoneal) lymph nodes [45]. Young infants seem to be at risk for disseminated infection [89].…”

Section: Candida Infections In Cgd Patientsmentioning

confidence: 99%

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Fungal infections in primary immunodeficiencies

2007

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“…Nevertheless, Candida lymphadenitis in the infant is very suspicious for CGD [54][55][56]. In case of Aspergillus infections, the lymph nodes involved are often those draining the site of infection.…”

Section: Other Organ Involvementmentioning

confidence: 98%

Invasive Fungal Infections in Patients with Chronic Granulomatous Disease

Henriet

Verweij

Holland

et al. 2012

Advances in Experimental Medicine and Biology

103

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Invasive fungal infections are a major threat for chronic granulomatous disease (CGD) patients. The present study provides a comprehensive overview of published invasive fungal infections in the CGD host through an extensive review of epidemiological, clinical, diagnostic and therapeutic data. In addition to the often mild clinical presentation, the currently used diagnostics for invasive aspergillosis have low sensitivity in CGD patients and cannot be easily translated to this non-neutropenic host. Aspergillus fumigatus and A. nidulans are the most commonly isolated species. A. nidulans infections are seldom reported in other immunocompromised patients, indicating a unique interaction between this fungus and the CGD host. The occurrence of mucormycosis is mainly noted in the setting of treatment of inflammatory complications with immunosuppressive drugs. Candida infections are infrequently seen and do not cause mucocutaneous disease but do show an age-dependent clinical presentation. The CGD patient is susceptible to a wide range of fungal pathogens, indicating the need to determine the causative fungus, often by invasive diagnostics, to guide optimal and rational treatment. This review summarizes current understanding of invasive fungal infections in patients with CGD and will serve as a starting point to guide optimal treatment strategies and to direct further research aimed at improving outcomes.

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“…Infections caused by this species occur relatively infrequently, particularly in comparison with the five most common Candida spp., and are extensively reviewed elsewhere (Bariola and Saccente 2008;Hawkins and Baddour 2003;Hazen 1995;Viudes et al 2002;Yinnon et al 1992). Most cases are reported as fungemia often linked with permanent catheters, but C. lusitaniae also appears to be the causative agent of peritonitis (after continuous outpatient dialysis), cholecystitis, aortic valve endocarditis, osteomyelitis, arthritis, bursitis, urinary tract infection, recurrent vaginitis, chorioamnionitis in pregnant women, necrotizing granulomatous lymphadenitis, and severe skin infection (Bariola and Saccente 2008;Cinar et al 2002;Estrada et al 2006;Favel et al 2003;Kjaeldgaard et al 1990;Michel et al 2009;Michel-Nguyen et al 1996;Silverman et al 2001;Viudes et al 2002;Yildirim et al 2008). Although the source of the infection is usually endogenous in the referred cases (King et al 1995;Pfaller et al 1994), exogenous (Fowler et al 1998;Sanchez et al 1992).…”

Section: Discussionmentioning

confidence: 96%

Usefulness of McRAPD for typing and importance of biofilm production in a case of nosocomial ventriculoperitoneal shunt infection caused by Candida lusitaniae

Hamal

Hanzen²,

Horn

et al. 2011

Folia Microbiol

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A case report of ventriculoperitoneal shunt infection caused by Candida lusitaniae in a 6-year-old patient with cerebral astrocytoma and obstructive hydrocephalus is presented briefly with emphasis on the course of antifungal treatment. Seven isolates recovered subsequently from the cerebrospinal fluid were studied retrospectively. To confirm identity, isolates were typed using pulsed-field gel electrophoresis and melting curve of random amplified polymorphic DNA (McRAPD). Further, the ability to form biofilm and its susceptibility to systemic antifungals were evaluated. Using McRAPD, identity of C. lusitaniae isolates showing slight microevolutionary changes in karyotypes was undoubtedly confirmed; successful application of numerical interpretation of McRAPD for typing is demonstrated here for the first time. The strain was also recognized as a strong biofilm producer. Moreover, minimum biofilm inhibitory concentrations were very high, in contrast to low antifungal minimum inhibitory concentrations of isolates. It can be concluded that McRAPD seems to be a simple and reliable method not only for identification but also for typing of yeasts. A ventriculoperitoneal shunt colonized by C. lusitaniae was revealed as the source of this nosocomial infection, and the ability of the strain to form biofilm on its surface likely caused treatment failure.

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Candida lusitaniae and Chronic Granulomatous Disease

Cited by 13 publications

References 4 publications

Fungal infections in primary immunodeficiencies

Fungal infections in primary immunodeficiencies

Invasive Fungal Infections in Patients with Chronic Granulomatous Disease

Usefulness of McRAPD for typing and importance of biofilm production in a case of nosocomial ventriculoperitoneal shunt infection caused by Candida lusitaniae

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