Immigration Brings New Pathology with No Standardized Treatment Protocol

Harrington, Tara; Eldredge, Denten; Benson, Erica K.

doi:10.7547/17-058

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…Optimal treatment and duration of therapy for this fungus are not well established, and data about Phaeoacremonium infection are scarce 9,22,23 . Amphotericin B is the most commonly used agent and is sometimes combined with the azoles 4,23 .…”

Section: Discussionmentioning

confidence: 99%

Fungal Osteomyelitis due to Phaeoacremonium venezuelense

Rodriguez-Materon

Trynz

SanGiovanni

2022

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Case: A 56-year-old immunosuppressed man presented with pain and swelling in the medial and anterior right foot with accompanied numbness in the second and third toes 1 month after a puncture wound by a Sylvester palm tree thorn. An intraoperative culture/biopsy returned positive for septic arthritis of the naviculocuneiform joint and fungal osteomyelitis of the navicular, medial, and intermediate cuneiforms due to Phaeoacremonium venezuelense. Conclusion: Fungal osteomyelitis is extremely rare. Only 5 cases by Phaeoacremonium venezuelense have been reported previously in the literature. To the best of our knowledge, this is the first case of osteomyelitis by this strain.

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Section: Discussionmentioning

confidence: 99%

Fungal Osteomyelitis due to Phaeoacremonium venezuelense

Rodriguez-Materon

Trynz

SanGiovanni

2022

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“…The incidence of eumycetoma in the United States is most likely higher than thought because of the presence of millions of immigrants from tropical and subtropical regions. 16,17 It is therefore necessary to raise awareness of the clinical presentation, differential diagnosis, imaging investigation, pathologic features, and treatment of eumycetoma to clinicians, especially podiatrists and dermatologists.…”

Section: Discussionmentioning

confidence: 99%

Eumycetoma, A Neglected Tropical Disease in the United States

Tritto,

Procop,

Billings

et al. 2021

Journal of the American Podiatric Medical Association

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Eumycetoma, caused by fungi, is a neglected tropical disease. It is endemic in the “mycetoma belt” countries but rare in North America. We report a case of pedal eumycetoma in the state of Maryland. A 51-year-old male immigrant from Guatemala presented with multiple, enlarging nodules on the dorsal surface of his left great toe present for 1 year, and a new one in the left arch area present for 6 months. The nodular lesions were surgically excised in two separate operations. Pathologic evaluation of all nodules revealed eumycetomas characterized by the Splendore-Hoeppli phenomenon, showing an amorphous eosinophilic center filled with numerous fungal hyphae, observed on periodic acid-Schiff–stained slides, with a surrounding cuff of neutrophils. Polymerase chain reaction–based sequencing identified Cladosporium cladosporioides in the tissues. The patient was further treated with oral fluconazole for 2 months. The patient recovered well postoperatively and had no recurrence at 20-month follow-up. In conclusion, even though eumycetoma is regarded as a rare disease in North America, its incidence may be higher than reported because of millions of immigrants from endemic regions in the United States, which highlights the need to raise awareness of this devastating disease in the medical community. Eumycetoma needs to be differentiated from other infectious and noninfectious benign and malignant lesions. Optimal treatment includes surgical excision with antifungal therapy.

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“…Si bien se incluyen al menos 41 especies de hongos implicadas en estos procesos [ 3 ], a nivel mundial más del 90% de los mismos se asocian a cuatro agentes etiológicos: Madurella mycetomatis, Madurella (Trematosphaeria) grisea, Pseudallescheria (Scedosporium) boydii y Leptophaeria (Falciformispora) senegalensis [ 2 ]. Otras múltiples especies, entre las que destacan las de los géneros Phialemonium [ 4 ] y Fusarium [ 2 ] han sido descritas como causas de esta entidad, aunque con mucha menor frecuencia.…”

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