First Case of Rhinocerebral Mucormycosis Caused by Lichtheimia ornata, with a Review of Lichtheimia Infections

Pan, Junling; Tsui, Clement K. M.; Li, Mengxing; Xiao, Kun; Hoog, G. S. de; Verweij, Paul E.; Cao, Yu; Lü, Hongguang; Jiang, Yanping

doi:10.1007/s11046-020-00451-y

Cited by 20 publications

(29 citation statements)

References 33 publications

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“…Род Lichtheimia принадлежит семейству Lichtheimiaceae, порядок Mucorales. Род Lichtheimia в настоящее время содержит шесть признанных видов: L. lakesleeana, L. brasiliensis, L. corymbifera, L. ornata, L. ramosa и L. sphaerocystis, из которых L. corymbifera и L. ramosa признаны клинически важными видами [18], обусловливающими развитие COVID-M, характеризующегося высокой летальностью [1].…”

Section: результаты и обсуждениеunclassified

Clinical case of rhino-orbital mucormycosis in a convalescent COVID-19 patient: diagnostic and treatment tactics

Popova

Demina

Zaytseva

et al. 2022

Russian Journal of Infection and Immunity

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According to current data, SARS-CoV-2 virus has the ability to cause multi-organ pathology, leading to acute damage of various organs and systems and long-term consequences characterized by polymorphic symptoms. Recently, a high incidence of invasive mycoses, particularly mucormycosis COVID-M, has been noted among the COVID-19 complications. The predisposing factor for the development of this pathology is diabetes mellitus, immunodeficiency states, and prolonged use of high doses of glucocorticosteroids. Mucormycosis is characterized by severe clinical manifestations and high lethality, and timely diagnostics of this pathology often represents a difficult problem. The aim of this study was to analyze a clinical case of rhino-orbital mucormycosis in convalescent COVID-19 patient. In the study, there was used mucopurulent nasal discharge from the patient previously hospitalized with a severe novel coronavirus infection. Here, we describe the methodology allowing to isolate and identify a pure mold fungus culture from the biomaterial using methods of routine bacteriology and MALDI-ToF mass spectrometry. Direct microscopy examination of nasal cavity discharge revealed branched non-septic hyphae with a characteristic branching angle, allowing to preliminarily diagnose invasive mucormycosis. Growth of mycelial fungus colony was observed by using Sabourauds medium with potassium tellurite. Microscopy of the pure culture revealed branching mycelium without septa, broad, with irregular thickness, unsegregated hyphae, and sporangia with a typical column specific to mucormycetes. Analysis of the obtained mass spectra allowed to establish the microbial species identity as Lichtheimia corymbifera. The latter along with other members of the order Mucorales, are known to cause mucormycosis. As a result of antifungal treatment (Amphotericin B) and timely surgical intervention, the patient was discharged from the hospital with prominent clinical improvement and no complaints during further outpatient follow-up period. The analysis of this clinical case showed the lack of alertness in some clinical diagnostic laboratories to detect pathogens of invasive mycoses. To avoid errors, while making a diagnosis, attention should be paid not only to detection of fungal spores in clinical material, but also take into account the structure of mycelium underlying major difference between yeast-like fungi, higher and lower molds. The isolation and identification of a pure pathogen culture allows to confidently verify the diagnosis, timely correct the treatment tactics and monitor circulation of mycotic agents to prevent occurrence of mycoses in most vulnerable patients cohorts.

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Section: результаты и обсуждениеunclassified

Clinical case of rhino-orbital mucormycosis in a convalescent COVID-19 patient: diagnostic and treatment tactics

Popova

Demina

Zaytseva

et al. 2022

Russian Journal of Infection and Immunity

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“…Lichtheimia spp., among others, have been reported to be associated with speciesdependent human pathogenic potential [46][47][48][49][50][51][52][53], including rhino-cerebral mucormycosis [54]. As is typical for mucormycoses, Lichtheimia spp.…”

Section: Introductionmentioning

confidence: 97%

Risk Assessment for Molds in the Vicinity of a Child Requiring Peritoneal Dialysis Living in a Rural Northern German Area

Zautner

Frickmann

Podbielski³

2021

Microorganisms

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As well as severe immunosuppression, other predisposing factors may facilitate invasive mycosis caused by molds. Chronic kidney disease and the resulting peritoneal dialysis have been reported as factors putting patients at risk of fungal infections from environmental sources. We describe an environmental investigation undertaken to guide exposure prevention for a peritoneal dialysis patient with transient colonization of her nostrils by Lichtheimia corymbifera in a rural area of northern Germany. Systematic screening for airborne and surface-deposited molds enabled targeted recommendations to be made, although Lichtheimia corymbifera itself was not grown from the collected environmental samples. This communication is intended to illustrate how such an investigation can be performed on the basis of the environmental distribution of the molds and how preventive recommendations can be derived from the results.

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“…However, the early symptoms are unusual, and traditional etiological detection methods are ineffective. Clinically, most Lichtheimia infections were treated empirically with no definite diagnosis ( 16 , 17 ). Early diagnosis and treatment can result in a better prognosis ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Case report: A rare case of pulmonary mucormycosis caused by Lichtheimia ramosa in pediatric acute lymphoblastic leukemia and review of Lichtheimia infections in leukemia

Liu²,

Zhang³

et al. 2022

Front. Oncol.

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Mucormycosis caused by Lichtheimia ramosa is an emerging and uncommon opportunistic infection in patients with hematological malignancies, with high mortality rates. Herein, we first report a case of pulmonary mucormycosis with Lichtheimia ramosa in a 3-year-old girl recently diagnosed with B-cell acute lymphoblastic leukemia. The diagnosis was made using computerized tomography of the lung, metagenomic next-generation sequencing (mNGS) of blood and sputum specimens, and microscopic examination to detect the development of Lichtheimia ramosa on the surgical specimen. She was effectively treated after receiving prompt treatment with amphotericin B and posaconazole, followed by aggressive surgical debridement. In our case, the fungal isolates were identified as Lichtheimia ramosa using mNGS, which assisted clinicians in quickly and accurately diagnosing and initiating early intensive treatment. This case also indicated the importance of strong clinical suspicion, as well as aggressive antifungal therapy combined with surgical debridement of affected tissues.

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First Case of Rhinocerebral Mucormycosis Caused by Lichtheimia ornata, with a Review of Lichtheimia Infections

Cited by 20 publications

References 33 publications

Clinical case of rhino-orbital mucormycosis in a convalescent COVID-19 patient: diagnostic and treatment tactics

Clinical case of rhino-orbital mucormycosis in a convalescent COVID-19 patient: diagnostic and treatment tactics

Risk Assessment for Molds in the Vicinity of a Child Requiring Peritoneal Dialysis Living in a Rural Northern German Area

Case report: A rare case of pulmonary mucormycosis caused by Lichtheimia ramosa in pediatric acute lymphoblastic leukemia and review of Lichtheimia infections in leukemia

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