<i>Exophiala jeanselmei</i> infection in solid organ transplant recipients: report of two cases and review of the literature

Lief, M.H.; Caplivski, D.; Bottone, Edward J.; Lerner, Seth P.; Vidal, Claudia I.; Huprikar, Shirish

doi:10.1111/j.1399-3062.2010.00552.x

Cited by 19 publications

(13 citation statements)

References 31 publications

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“…Certain species tend to cause cutaneous infections at sites of inoculation, presenting as papules, nodules or pustules, while others cause pulmonary or disseminated (including CNS) disease. (7, 8, 42-45)(46, 47)(48). …”

Section: Specific Fungimentioning

confidence: 99%

Emerging Fungal Infections in Solid Organ Transplant Recipients

Shoham

2013

Infectious Disease Clinics of North America

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The most important emerging and rare fungal pathogens in solid organ transplant recipients are the Zygomycetes, Scedosporium, Fusarium and the dark molds. Factors impacting the emergence of these fungi include the combination of intensive immunosuppressive regimens with increasingly widespread use of long-term azole antifungal therapy; employment of aggressive diagnostic approaches (e.g. sampling of bronchoalveolar lavage fluid) and changes in patients’ interactions with the environment. Early diagnosis, differentiation between colonization and infection and institution of appropriate therapy is vital when contending with these fungi. Moreover, effective treatment often requires a multi-disciplinary approach. This article reviews the epidemiology, microbiology and clinical impact of emerging fungal infections in solid organ transplant recipients and provides up to date recommendations on their treatment.

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Section: Specific Fungimentioning

confidence: 99%

Emerging Fungal Infections in Solid Organ Transplant Recipients

Shoham

2013

Infectious Disease Clinics of North America

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“…In renal transplant recipients, a major series reported a cumulative prevalence of phaeohyphomycosis of about 0.34–0.44% . To our knowledge, no case of phaeohyphomycosis secondary to E. xenobiotica in a kidney transplant recipients has been published previously (Table S1; ).…”

Section: Discussionmentioning

confidence: 90%

“…Serious infections caused by a variety of opportunistic fungi are increasingly reported in solid organ transplant (SOT) recipients . As these now represent approximately 7–10% of fungal infections among SOT recipients, they are collectively considered as “emerging fungal infections.” Current knowledge on their epidemiology, clinical course, and antifungal management strategies is limited . Phaeohyphomycosis, one of the least known emerging fungal infection in SOT, which is diagnosed by the identification of dark‐pigmented fungal elements in histopathologic samples from infected tissues, is produced by various black fungi (sometimes referred as “dematiaceous”) such as Exophiala , Alternaria , or Bipolaris species.…”

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confidence: 99%

“…In this report, we present a new case of disseminated Exophiala xenobiotica infection in a kidney transplant recipient that did not respond to prolonged azole therapy (fluconazole followed by voriconazole). The literature on phaeohyphomycosis has been recently reviewed elsewhere . Herein, we provide an update summary of the cases of Exophiala species infections in the context of kidney transplantation.…”

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confidence: 99%

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Multifocal phaeohyphomycosis caused by Exophiala xenobiotica in a kidney transplant recipient

Palmisano

Morio

Pape

et al. 2015

Transplant Infectious Dis

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In recent years, black fungi have been increasingly reported as causing opportunistic infections after solid organ transplantation. Here, we report a case of insidious, relentless, and multifocal Exophiala xenobiotica infection in a kidney transplant recipient that eventually required multiple surgical excisions along with oral and intravenous antifungal combination therapy using liposomal amphotericin B and posaconazole. We compare the present case with all previously reported cases of Exophiala infection after kidney transplantation.

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“…Due to their phenotypic characteristics at the beginning of colony formation, these fungi are often also referred to as "black yeasts" (7), a misnomer which sometimes may mislead the choice of antifungal agents. When the cultures mature, brown hyphae are formed which bear conidiogenous cells referred to as annellides, a typical characteristic of this genus of fungi (8).…”

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Clinical Spectrum of Exophiala Infections and a Novel Exophiala Species, Exophiala hongkongensis

et al. 2013

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We characterized 12 Exophiala strains isolated from patients over a 15-year period to the species level using phenotypic tests and internal transcribed spacer (ITS) and Rpb1 sequencing and described the clinical spectrum of the 12 patients. Eight patients had nail or skin infections, two had invasive infections, and two had colonization of the gastrointestinal tract. ITS and Rpb1 sequencing showed that 11 of the 12 strains were known Exophiala species (E. oligosperma, and E. xenobiotica [n ‫؍‬ 1]), which included the first reported cases of onychomycosis caused by E. bergeri and E. oligosperma. The 12th strain (HKU32 T ), isolated from the nail clipping of the right big toe of a 68-year-old female patient with onychomycosis, possessed unique morphological characteristics distinct from other Exophiala species. It grew very slowly and had a velvety colony texture after 28 days, short conidiophores of the same olivaceous color as the supporting hyphae, numerous spores, and no chlamydospore-like cells. ITS, Rpb1, ␤-tubulin, and ␤-actin gene sequencing unambiguously showed that HKU32 T was clustered with but formed branches distinct from other Exophiala species in phylogenetic trees. We propose the new species Exophiala hongkongensis to describe this novel fungus.

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Exophiala jeanselmei infection in solid organ transplant recipients: report of two cases and review of the literature

Abstract: Dematiaceous fungi are an opportunistic pathogen seen in solid organ transplant recipients. We report 2 cases of Exophiala infection and review the medical literature to summarize the spectrum of disease this pathogen can cause in this patient population.

Cited by 19 publications

References 31 publications

Emerging Fungal Infections in Solid Organ Transplant Recipients

Emerging Fungal Infections in Solid Organ Transplant Recipients

Multifocal phaeohyphomycosis caused by Exophiala xenobiotica in a kidney transplant recipient

Clinical Spectrum of Exophiala Infections and a Novel Exophiala Species, Exophiala hongkongensis

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