Case Report. Phaeohyphomycosis caused by <i>Phialophora verrucosa</i> developed in a patient with non‐HIV acquired immunodeficiency syndrome

Ohira, Sayuri; Isoda, Kenichi; Hamanaka, Hiroko; Takahashi, Keiichi; Nishimoto, Katsutaro; Mizutani, Hitoshi

doi:10.1046/j.1439-0507.2002.00701.x

Cited by 10 publications

(1 citation statement)

References 18 publications

(23 reference statements)

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“…Within the black fungal group of aetiologic agents, particularly Phialophora species are encountered: nine cases of this rare disorder have been published with a phialophora‐like agent, which is close to 10% of all CARD9‐related cases published to date. Other than CARD9, Phialophora species have been proven to occur as aetiologic agents of CBM 5 as well as of PHM, 6,7 but most siblings of the species group are environmental 8 …”

Section: Introductionmentioning

confidence: 99%

Comparative genomics of opportunistic Phialophora species involved in divergent disease types

Song

Silva

Vicente

et al. 2021

Mycoses

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Background Black opportunists Phialophora verrucosa complex species can cause different disease types in competent and in immunocompromised individuals, but are remarkably overrepresented in CARD9‐related infections. Objectives To better understand the ecology and potential pathogenicity of opportunistic Phialophora species and reveal eventual genetic parameters associated with the behaviour in vivo and genetic profiles in patients with CARD9 immunodeficiency. Methods Genomes of 26 strains belonging to six species of the Phialophora verrucosa complex were sequenced. Using multilocus analysis, all environmental and clinical strains were identified correctly. We compared the genomes of agents from different disease types among each other including CARD9 immunodeficiency. Results We obtained genome sizes of the 26 Phialophora strains ranged between 32 and 37 MB. Some species showed considerable intraspecific genomic variation. P americana showed the highest degree of variability. P verrucosa was variable in CAZy enzymes, whereas P americana varied in PKS‐related genes. Phialophora species, particularly P verrucosa, are relatively frequent in patients with CARD9‐related immunodeficiency. Different mutations in the CARD9 gene seem to increase susceptibility for infection by different groups of species, that is either Candida, dermatophytes or black fungi. A number of patients with chromoblastomycosis revealed an as yet unknown CARD9 mutation. TNFα impairment was prevalent in patients with CARD9 infections, while CBM patients were invariably IFNγ. Conclusions From genomic investigations, the known virulence factors between clinical and environmental strains did not reveal any significant difference. Phialophora complex has an equal chance to cause infection in humans, either healthy or CARD9‐impaired.

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Section: Introductionmentioning

confidence: 99%

Comparative genomics of opportunistic Phialophora species involved in divergent disease types

Song

Silva

Vicente

et al. 2021

Mycoses

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Subcutaneous and Deep Mycoses

Grossman

Fox

Kovarik

et al. 2011

Cutaneous Manifestations of Infection in the Immunocompromised Host

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Recalcitrant Primary Subcutaneous Phaeohyphomycosis Due to Phialophora verrucosa

Gao

Wang

et al. 2012

Mycopathologia

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Phialophora verrucosa has rarely been reported for causing phaeohyphomycosis, which tends to occur in immunocompromised individuals. The case of primary subcutaneous phaeohyphomycosis due to P. verrucosa in an otherwise healthy Chinese female is presented. The girl presented with asymptomatic skin lesions when she was only 16 year old. Histological examinations revealed multiple dematiceous hyphael elements in the dermis and subcutaneous tissues. Fungal cultures were identified as P. verrucosa repeatedly based on the morphological features and confirmed by the internal transcribed spacer region nucleotide sequencing. The infection was so extremely recalcitrant that prolonged systemic antifungal regimens for 12 years revealed limited effect. The skin lesions slowly progressed and caused marked disfigurement despite the encouraging results of in vitro susceptibility. However, no relevant side effects have been reported in the course, and the patient gave birth to a healthy baby while under the maintenance treatment of itraconazole and terbinafine. This case is special in terms of the early onset, the rare clinical aspect of the pathogen, the discrepancy between in vitro and in vivo antifungal activities and especially the prolonged and recalcitrant course in such an otherwise healthy host.

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Case Report. Phaeohyphomycosis caused by Phialophora verrucosa developed in a patient with non‐HIV acquired immunodeficiency syndrome

Cited by 10 publications

References 18 publications

Comparative genomics of opportunistic Phialophora species involved in divergent disease types

Comparative genomics of opportunistic Phialophora species involved in divergent disease types

Subcutaneous and Deep Mycoses

Recalcitrant Primary Subcutaneous Phaeohyphomycosis Due to Phialophora verrucosa

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