<i>Exophiala dermatitidis</i> endocarditis on native aortic valve in a postrenal transplant patient and review of literature on <i>E. dermatitidis</i> infections

Patel, Atul; Patel, Ketan; Darji, Prakash; Singh, R. P.; Shivaprakash, M. R.; Chakrabarti, Arunaloke

doi:10.1111/myc.12009

Cited by 40 publications

(58 citation statements)

References 45 publications

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“…Clinical manifestations of disease can range from localized subcutaneous nodules to highly invasive infections such as brain abscesses, meningitis, and endocarditis [1, 6, 8]. Fungi are a less common cause of infective endocarditis and account for less than 10 percent of cases [13].…”

Section: Discussionmentioning

confidence: 99%

“…Fungi are a less common cause of infective endocarditis and account for less than 10 percent of cases [13]. There are only two previous reports of E. dermatitidis endocarditis in the literature [8, 9]. As described earlier, Vartian et al reported the first known case of endocarditis secondary to E. dermatitidis with a clear mode of acquisition in the setting of intravenous drug use.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, there have been only two previous cases reported of aortic valve endocarditis secondary to E. dermatitidis infection. One occurred in a patient who was immune compromised and the second case was in a patient with a clear risk of acquisition in the setting of active intravenous drug use [8, 9]. The case we discuss below is the first report of E. dermatitidis infection of a prosthetic aortic valve and aortic graft in an immune competent patient.…”

Section: Introductionmentioning

confidence: 99%

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Exophiala (Wangiella) dermatitidis Prosthetic Aortic Valve Endocarditis and Prosthetic Graft Infection in an Immune Competent Patient

Berger

Cusumano

DeRose

et al. 2017

Case Reports in Infectious Diseases

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exophiala (Wangiella) dermatitidis Prosthetic Aortic Valve Endocarditis and Prosthetic Graft Infection in an Immune Competent Patient

Berger

Cusumano

DeRose

et al. 2017

Case Reports in Infectious Diseases

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“…The patient in this case received extended treatment with itraconazole and responded well. Treatment of infections caused by Exophiala species often involves the use of triazoles, such as itraconazole, posaconazole, and voriconazole, which are sometimes combined with amphotericin B or surgical incision if possible (5,31). However, the optimal treatment is unknown, as no comparative clinical trials have been conducted.…”

Section: Discussionmentioning

confidence: 99%

“…For example, E. dermatitidis has been shown to cause central nervous system infections in immunocompetent individuals in Asia and cutaneous and subcutaneous infections in immunocompromised individuals, as well as catheter-associated fungemia, endocarditis, lymphadenitis, peritonitis, and pneumonia and both invasive disease and colonization of the airways of cystic fibrosis patients (23)(24)(25)(26)(27)(28)(29)(30)(31). Other species that are associated with cutaneous and subcutaneous infections include E. xenobiotica, which was the most frequently detected black yeast from cutaneous sources in one report (3), and E. oligosperma (3,5).…”

Section: Discussionmentioning

confidence: 99%

Morphological and Molecular Characterization of Exophiala polymorpha sp. nov. Isolated from Sporotrichoid Lymphocutaneous Lesions in a Patient with Myasthenia Gravis

et al. 2015

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c Exophiala species are capable of causing cutaneous and subcutaneous infections in immunocompromised patients. An Exophiala isolate was cultured from a biopsy specimen of a lesion on the forearm of a patient with myasthenia gravis. The patient also had lesions on the palm and distal aspects of the hand, which were successfully treated with a long-term course of itraconazole. A detailed morphological and molecular characterization of the isolate was undertaken. Phylogenetic analysis of the internal transcribed spacer region and portions of the ␤-tubulin and translation elongation factor 1-alpha genes indicated that the isolate was a novel species closely related to but genetically distinct from species within the Exophiala spinifera clade; the name Exophiala polymorpha sp. nov. is proposed. Morphologically, E. polymorpha most closely resembles E. xenobiotica but it differs in possessing phialides bearing prominent, wide collarettes, and it does not produce chlamydospores. E xophiala species are phaeoid, conidial fungi that are widely distributed in decaying wood, soil, plants, and water. They are capable of causing phaeohyphomycosis, including localized infections following traumatic implantation to disseminated disease (1, 2). Although cutaneous/subcutaneous phaeohyphomycosis incited by Exophiala species is relatively uncommon, several species of black yeasts identified by molecular means have been reported as etiologic agents. In the largest study to date in which 188 clinical isolates were characterized by internal transcribed spacer (ITS) sequencing and phenotypic features (3), 38.3% and 0.5% of the study isolates were from cutaneous and superficial sites, respectively. Subcutaneous isolates represented 12% of the strains and included Exophiala bergeri, E. dermatitidis, E. jeanselmei, E. lecanii-corni, E. mesophila, E oligosperma, E. phaeomuriformis, E. spinifera, and E. xenobiotica. While limited clinical information precluded documentation of these isolates as etiologic agents, their recovery and characterization highlighted the diversity of species seen in the clinical setting. A sampling of literature reports shows some of the same species seen in the above study, including E. oligosperma as an agent of olecranon bursitis (4), disseminated subcutaneous disease in a patient with systemic lupus erythematosus (5), and a patient with Wegener's granulomatosis (6), multiple reports of E. spinifera cutaneous/subcutaneous disease (7,8), and E. xenobiotica in a patient with non-Hodgkin lymphoma (9). We report here subcutaneous sporotrichoid lesions by Exophiala polymorpha, sp. nov. in a patient with myasthenia gravis. CASE REPORTThe patient is a 68-year-old African-American woman who complained of a right palmar painless nodule of about 6 months' duration prior to presentation. She reported that the lesion started like a callus in the middle of her right palm. This lesion gradually enlarged, and she started having sporotrichoid nodular lesions developing on the dorsum of her hand, wrist, forearm, and antecubita...

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Phaeohyphomycosis Due to Exophiala jeanselmei: An Emerging Pathogen in India—Case Report and Review

et al. 2015

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We present a rare case of a 30-year-old woman who presented with a swelling on the lateral aspect of her left forearm, present since 6 months, adjacent to a 16-year-old burn scar. X-ray of elbow joint and forearm revealed the subcutaneous nature of the swelling. Giemsa and periodic acid-Schiff-stained smears and potassium hydroxide mount of fine-needle aspirate of the swelling revealed dematiaceous, branching, and septate fungal hyphae. Fungal culture of the aspirated pus showed growth of Exophiala jeanselmei. Histopathological examination revealed brown-coloured hyphae with foreign body giant cell reaction and palisading granulomas in the surrounding tissue. The patient was successfully treated with surgical excision of the swelling. All the cases of phaeohyphomycosis due to Exophiala spp. in India are also reviewed.

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Exophiala dermatitidis endocarditis on native aortic valve in a postrenal transplant patient and review of literature on E. dermatitidis infections

Cited by 40 publications

References 45 publications

Exophiala (Wangiella) dermatitidis Prosthetic Aortic Valve Endocarditis and Prosthetic Graft Infection in an Immune Competent Patient

Exophiala (Wangiella) dermatitidis Prosthetic Aortic Valve Endocarditis and Prosthetic Graft Infection in an Immune Competent Patient

Morphological and Molecular Characterization of Exophiala polymorpha sp. nov. Isolated from Sporotrichoid Lymphocutaneous Lesions in a Patient with Myasthenia Gravis

Phaeohyphomycosis Due to Exophiala jeanselmei: An Emerging Pathogen in India—Case Report and Review

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