Fungemia Secondary to Gastrointestinal Mucor indicus Infection

Aboltins, Craig; Pratt, William; Solano, Thomas

doi:10.1086/498751

Cited by 24 publications

(16 citation statements)

References 7 publications

(15 reference statements)

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“…These results implicate Mucor species as potential causal agents for serious food-borne illness, especially for immunocompromised patients. A series of case reports of gastrointestinal mucormycosis further supports that Mucor can cause fatal fungal infections through ingestion of contaminated foods or medicines (15–18, 29). …”

Section: Discussionmentioning

confidence: 89%

“…The main infection sites are the lungs, the sinuses, soft tissues, skin, and the bloodstream (12, 13). Gastrointestinal (GI) mucormycosis causes symptoms that include nonspecific abdominal tenderness and distention with nausea and vomiting, and case reports (14) have been published (15–18). Transplant recipients are especially susceptible to gastrointestinal mucormycosis following ingestion of causative fungal species (17).…”

Section: Introductionmentioning

confidence: 99%

“…One such case was reported in a bone marrow transplant recipient who ingested naturopathic medicine contaminated with Mucor , resulting in the development of gastrointestinal mucormycosis (16). The mortality rate of gastrointestinal mucormycosis is as high as 85%, and the infection is often disseminated, resulting in higher rates of mortality (15). …”

Section: Introductionmentioning

confidence: 99%

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Analysis of a Food-Borne Fungal Pathogen Outbreak: Virulence and Genome of a Mucor circinelloides Isolate from Yogurt

Lee

Billmyre

et al. 2014

mBio

113

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Food-borne pathogens are ongoing problems, and new pathogens are emerging. The impact of fungi, however, is largely underestimated. Recently, commercial yogurts contaminated with Mucor circinelloides were sold, and >200 consumers became ill with nausea, vomiting, and diarrhea. Mucoralean fungi cause the fatal fungal infection mucormycosis, whose incidence has been continuously increasing. In this study, we isolated an M. circinelloides strain from a yogurt container, and multilocus sequence typing identified the strain as Mucor circinelloides f. circinelloides. M. circinelloides f. circinelloides is the most virulent M. circinelloides subspecies and is commonly associated with human infections, whereas M. circinelloides f. lusitanicus and M. circinelloides f. griseocyanus are less common causes of infection. Whole-genome analysis of the yogurt isolate confirmed it as being close to the M. circinelloides f. circinelloides subgroup, with a higher percentage of divergence with the M. circinelloides f. lusitanicus subgroup. In mating assays, the yogurt isolate formed sexual zygospores with the (−) M. circinelloides f. circinelloides tester strain, which is congruent with its sex locus encoding SexP, the (+) mating type sex determinant. The yogurt isolate was virulent in murine and wax moth larva host systems. In a murine gastromucormycosis model, Mucor was recovered from fecal samples of infected mice for up to 10 days, indicating that Mucor can survive transit through the GI tract. In interactions with human immune cells, M. circinelloides f. lusitanicus induced proinflammatory cytokines but M. circinelloides f. circinelloides did not, which may explain the different levels of virulence in mammalian hosts. This study demonstrates that M. circinelloides can spoil food products and cause gastrointestinal illness in consumers and may pose a particular risk to immunocompromised patients.

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Analysis of a Food-Borne Fungal Pathogen Outbreak: Virulence and Genome of a Mucor circinelloides Isolate from Yogurt

Lee

Billmyre

et al. 2014

mBio

113

View full text Add to dashboard Cite

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“…A few reports in this review suggest that the IFIs were likely attributable to fungal contamination during processing (Lazar et al , 2014; Vallabhaneni et al , 2015b), whereas others may have been related to fungi intrinsically present in certain products (Sutherland and Jones, 1960; Radosavljevic et al , 1999) or to improper storage (Aboltins et al , 2006; Gurgui et al , 2011). Fungal food spoilage accounts for the loss of an estimated 5 to 10% of all food production (Pitt and Hocking, 2009) and is a particularly relevant topic for consumers.…”

Section: Discussionmentioning

confidence: 90%

“…In one case, a man from Australia developed acute abdominal pain, diarrhea, and fever 3 h after eating a meal that had been unrefrigerated for a day (Aboltins et al , 2006). The patient’s blood and feces cultures grew Mucor indicus , and he was successfully treated with 6 weeks of amphotericin B lipid preparations.…”

Section: Resultsmentioning

confidence: 99%

Invasive Fungal Infections Acquired from Contaminated Food or Nutritional Supplements: A Review of the Literature

Benedict

Chiller

Mody

2016

Foodborne Pathogens and Disease

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Fungi are an integral part of the natural environment and, therefore, play many roles in relation to food: some fungi are used in food production, some are food sources themselves, and some are agents of food spoilage. Some fungi that contaminate food can also be harmful to human health. The harmful but noninfectious health consequences of mycotoxins have been well-characterized, but the extent to which fungi in food pose a risk for invasive infections is unknown. We conducted a literature review to identify cases of invasive fungal infections (IFIs) believed to have resulted from ingestion or inhalation of food, beverages, or dietary supplements (excluding Saccharomyces infections). We identified 11 publications describing cases or small outbreaks of IFIs related to foods or beverages and three describing IFIs related to dietary supplements. These food-associated IFIs were predominantly mold infections, and the few yeast infections were associated with dairy products. Suspected foodborne IFIs appear to be rare, but are increasingly described in the electronically searchable literature. They are associated with a variety of foods, are due to a variety of fungal pathogens, and primarily occur in persons with immunosuppressive conditions or other predisposing factors. Various guidelines for high-risk patients recommend avoidance of certain food products that may contain high levels of fungi, but further work is needed to evaluate the effectiveness of these restrictive diets in preventing fungal infections. The relationships between food spoilage, food insecurity, and IFI risk are another area that may warrant further exploration.

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A Pain in the Back: A 50-Year-Old Man with Pancreatitis and a Fever

DiMaggio

Landon

2017

The Infectious Disease Diagnosis

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Fungemia Secondary to Gastrointestinal Mucor indicus Infection

Cited by 24 publications

References 7 publications

Analysis of a Food-Borne Fungal Pathogen Outbreak: Virulence and Genome of a Mucor circinelloides Isolate from Yogurt

Analysis of a Food-Borne Fungal Pathogen Outbreak: Virulence and Genome of a Mucor circinelloides Isolate from Yogurt

Invasive Fungal Infections Acquired from Contaminated Food or Nutritional Supplements: A Review of the Literature

A Pain in the Back: A 50-Year-Old Man with Pancreatitis and a Fever

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