Identification and First Report of
 Inonotus
 (
 Phellinus
 )
 tropicalis
 as an Etiologic Agent in a Patient with Chronic Granulomatous Disease

Sutton, Deanna A.; Thompson, Elizabeth H.; Rinaldi, Michael G.; Iwen, Peter C.; Nakasone, Karen K.; Jung, Hack Sung; Rosenblatt, Howard M.; Paul, Mary E.

doi:10.1128/jcm.43.2.982-987.2005

Cited by 34 publications

(35 citation statements)

References 47 publications

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“…Most species described from clinical samples are white rotters on dead wood, assimilating polyaromatic ligneous hydrocarbons in the substrate, which leaves an overabundance of white, cellulosic material behind. This ecology is noted for the shelf fungi C. tabacinus (12), I. lacteus (13), I. tropicalis (14,15), P. undulatus (16), O. corticola (17), P. chrysosporium (7), S. commune, and B. adusta (11), as well as for C. lacerata described in the present communication. Clinical cases of infection by these shelf fungi almost exclusively concern pulmonary colonization, eventually leading to allergic responses but with limited invasion.…”

Section: Discussionsupporting

confidence: 78%

“…), and Phanerochaete chrysosporium (anamorph, Sporotrichum pruinosum), possess some morphological characteristics specific for their identification (4)(5)(6)(7)(8)(9)(10). Lately, lesser known members from this class of molds, such as Bjerkandera adusta (11), Cyclomyces tabacinus (12), Irpex lacteus (13), Inonotus (Phellinus) tropicalis (14,15), Phellinus undulatus (16), Oxyporus corticola (17), Volvariella volvacea (18), and Perenniporia spp. (4), have been incriminated as agents of human disease.…”

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Clinical Significance of Filamentous Basidiomycetes Illustrated by Isolates of the Novel Opportunist Ceriporia lacerata from the Human Respiratory Tract

et al. 2013

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eThe filamentous basidiomycete Ceriporia lacerata, an agent of white rot on wood, has never been reported in human disease and its clinical significance is not yet known. We describe 4 patients with respiratory diseases where C. lacerata was implicated in a wide spectrum of clinical manifestations ranging from saprobic colonization to fungal pneumonia. The isolates did not show the morphological characteristics that facilitate recognition of filamentous basidiomycetes, such as the presence of clamp connections, spicules along hyphae, or fruiting bodies. The identity of the mold was confirmed by sequencing the internal transcribed spacer 1 and 4 (ITS-1 and ITS-4) and D1/D2 regions of the rRNA gene. All of the isolates exhibited the lowest MICs of posaconazole and isavuconazole (MIC range, 0.06 to 0.125 g/ml), followed by itraconazole (MIC range, 0.06 to 0.5 g/ml), voriconazole (MIC range, 0.125 to 0.5 g/ml), and amphotericin B (MIC range, 0.25 to 1 g/ml). The infections reported here occurred in patients with preexisting lung damage induced by tuberculosis or chronic obstructive pulmonary disease. Chronic, sometimes fatal infections by the ascomycete Aspergillus fumigatus and the basidiomycete Schizophyllum commune are well established in the presence of an anatomical pulmonary defect or in the background of immunodeficiency. It is postulated that C. lacerata, a novel opportunist basidiomycete, may be involved in similar pathological processes.

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confidence: 78%

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confidence: 99%

Clinical Significance of Filamentous Basidiomycetes Illustrated by Isolates of the Novel Opportunist Ceriporia lacerata from the Human Respiratory Tract

et al. 2013

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“…1D). The recently reported species Inonotus (Phellinus) tropicalis (12,15,31), which is otherwise sterile in culture, may produce somewhat unusual hyphal elements known as setal hyphae (Fig. 1E); however, these types of hyphae may occur in other genera as well.…”

Section: Morphological Basidiomycete Identificationmentioning

confidence: 99%

Sequence-Based Identification of Filamentous Basidiomycetous Fungi from Clinical Specimens: a Cautionary Note

et al. 2010

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The species-level identification of sterile and/or arthroconidium-forming filamentous fungi presumed to be basidiomycetes based upon morphological or physiological features alone is usually not possible due to the limited amount of hyphal differentiation. Therefore, a reliable molecular approach capable of the unambiguous identification of clinical isolates is needed. One hundred sixty-eight presumptive basidiomycetes were screened by sequence analysis of the internal transcribed spacer (ITS) and D1/D2 ribosomal DNA regions in an effort to obtain a species identification. Through the use of this approach, identification of a basidiomycetous fungus to the species level was obtained for 167/168 of the isolates. However, comparison of the BLAST results for each isolate for both regions revealed that only 28.6% (48/168) of the isolates had the same species identification by use of both the ITS and the D1/D2 regions, regardless of the percent identity. At the less stringent genus-only level, the identities for only 48.8% (82/168) of the isolates agreed for both regions. Investigation of the causes for this low level of agreement revealed that 14% of the species lacked an ITS region deposit and 16% lacked a D1/D2 region deposit. Few GenBank deposits were found to be complete for either region, with only 8% of the isolates having a complete ITS region and 10% having a complete D1/D2 region. This study demonstrates that while sequence-based identification is a powerful tool for many fungi, sequence data derived from filamentous basidiomycetes should be interpreted carefully, particularly in the context of missing or incomplete GenBank data, and, whenever possible, should be evaluated in light of compatible morphological features.

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“…The Coprinopsis species are recognizable in culture by the formation of arthroconidial anamorphs (9). Recently, some lesser-known basidiomycete species, such as Cyclomyces tabacinus (18), Irpex lacteus (2), Inonotus (Phellinus) tropicalis (7,29), Oxyporus corticola (1), and Volvariella volvacea (25), have been added as causative agents of pulmonary and fatal deep-seated mycoses in humans and animals. Other basidiomycetes such as Phanerochaete chrysosporium (anamorph, Sporotrichum pruinosum) and Bjerkandera adusta have repeatedly been isolated from pulmonary sites and may also be pathogenic in some settings (12,15).…”

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First Human Case of Pulmonary Fungal Ball Due to a Perenniporia Species (a Basidiomycete)

et al. 2012

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e Perenniporia species are basidiomycetes, resupinate shelf fungi responsible for white rot decay of wood. Here, we report for the first time an intracavitary pulmonary fungal ball due to a species of Perenniporia that has not been recognized so far as a human pathogen. The fungus was identified by sequencing of the partial ribosomal operon of a culture from a clinical specimen. CASE REPORTA 55-year-old nonsmoking male from Assam, India, presented with complaints of intermittent right-sided nonanginal chest pain and 5 to 6 episodes of minor hemoptysis over a period of 1 month. The patient gave a history of having received antitubercular therapy 3 years before with a 6-month-long regimen containing rifampin, isoniazid, ethambutol, and pyrazinamide for sputum-smear-positive pulmonary tuberculosis, with which he had been compliant until declared cured by his physician. The patient was found to have uncontrolled diabetes mellitus as revealed by an HbA 1c level of 13%. He was previously evaluated in Assam, where a chest radiograph showed a cavity in the right upper and middle pulmonary zone. A contrast-enhanced computerized tomography (CECT) scan of his thorax revealed the presence of fibroparenchymal lesions with mild traction bronchiectasis in the right lung (sequelae of healed pulmonary tuberculosis) associated with a fungal ball in the right lower lobe (Fig. 1). The patient was treated with CT-guided percutaneous intracavitary injection of amphotericin B, though records of the dosing schedule could not be obtained. The patient was then referred to Delhi for mycological diagnosis and further management of the case. The patient underwent a fiber optic bronchoscopy (FOB) to rule out the possibility of reactivation of tuberculosis and for an investigative work-up for hemoptysis. The FOB showed no endobronchial lesion, active bleeding, or blood clots in the bronchi. A diagnostic bronchoalveolar lavage (BAL) fluid sample was taken from the apical segment of the right lower and postero-anterior basal segment of the right upper lobe.Mycological investigations. Direct microscopy of KOH wet mounts of the BAL fluid specimen revealed hyaline septate hyphae ( Fig. 2A). Cultures yielded multiple white, cottony colonies of identical molds on Sabouraud's glucose agar (SGA) plates incubated for 7 days at 28°C and 37°C. Subcultures on potato dextrose agar (PDA) incubated at 28°C and 37°C showed dense white cottony growth after 7 days (Fig. 2B), and slide cultures of the mold isolates on PDA at 28°C revealed hyaline septate hyphae with chlamydospore-like cells (Fig. 2C). No clamp connections or hyphal pegs were seen during up to 3 weeks of incubation. The isolate was assigned accession no. VPCI 85/P/10 (CBS 130020) for molecular identification and antifungal susceptibility testing. BAL fluid was also investigated microscopically after Gram and Ziehl-Neelsen (ZN) staining and cultured for aerobic pathogens and Mycobacterium spp. The Gram and ZN stains were negative, and cytology was negative for any malignant cells. No Mycobacterium...

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Identification and First Report of Inonotus ( Phellinus ) tropicalis as an Etiologic Agent in a Patient with Chronic Granulomatous Disease

Cited by 34 publications

References 47 publications

Clinical Significance of Filamentous Basidiomycetes Illustrated by Isolates of the Novel Opportunist Ceriporia lacerata from the Human Respiratory Tract

Clinical Significance of Filamentous Basidiomycetes Illustrated by Isolates of the Novel Opportunist Ceriporia lacerata from the Human Respiratory Tract

Sequence-Based Identification of Filamentous Basidiomycetous Fungi from Clinical Specimens: a Cautionary Note

First Human Case of Pulmonary Fungal Ball Due to a Perenniporia Species (a Basidiomycete)

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