Isolation of both Pseudozyma aphidis and Nocardia otitidiscaviarum from a mycetoma on the leg

Abstract

We describe a case of mycetoma which typified the classic presentation of the disease: a male farmer with affection of the lower limbs and a history of trauma. The patient presented with a swollen right lower limb showing multiple discharging sinuses for 25 years. Histopathologically, grains were found by HE stain, and clustered yeast-like cells were observed by PAS stain. The distinctive 'dot-in-circle' sign was found through MRI. Besides Nocardia otitidiscaviarum, Pseudozyma aphidis was isolated from deep tissue culture, and the identification of the etiologic species was ascertained by DNA sequencing. Generally speaking, Nocardia otitidiscaviarum is an infrequent cause of mycetoma, and Pseudozyma species are usually isolated from plant material rather than clinical specimens. This is the first case of mycetoma from which both Nocardia otitidiscaviarum and Pseudozyma aphidis were isolated.

First Case of Fungemia Due to Pseudozyma aphidis in a Pediatric Patient with Osteosarcoma in Latin America

“…However, on CHROMagar Candida, our isolates developed creamcolored colonies, in contrast with the findings of Prakash et al (14), and could not be identified using an API 20 AUX system. Due to this, sequencing of ITS and/or D1/D2 domains was necessary for proper identification, in agreement with the literature (8,(11)(12)(13)(14)(15). Also, isolates could not be identified by MALDI-TOF.…”

“…Unfortunately, we have no record of the patient dietary history. It is also worth noting that, as in the present work, three of the four cases in which P. aphidis were isolated involved pediatric patients (11,(13)(14)(15).…”

“…Since then, other cases of human infection due to Pseudozyma species have been reported: a CVCassociated infection due to P. aphidis in a child with short gut syndrome (11), a brain abscess associated with a Pseudozyma sp. in a patient with astrocytoma (12), a case of mycetoma associated with Nocardia otitidiscaviarum and P. aphidis (13), a fungemia due to P. aphidis in a neonate (14), a pulmonary infection due to P. aphidis in a patient with Burkitt lymphoma (15), and a new report that shows the isolation of three new additional Pseudozyma species (Pseudozyma alboarmeniaca sp. nov., Pseudozyma crassa sp.…”

Three new basidiomycetous yeasts, Pseudozyma alboarmeniaca sp. nov., Pseudozyma crassa sp. nov. and Pseudozyma siamensis sp. nov. isolated from Thai patients

“…Because there are few antifungal agents that are effective against Pseudozyma species, were unable to obtain any detailed information, including that concerning patients' life‐prognoses. Since we initially isolated these new Pseudozyma species from clinical specimens, a few reports of cases of infection with other Pseudozyma species have been published from the USA , China and South Korea, in 2008, 2010 and 2011, respectively. Pseudozyma aphidis was isolated from patients with central venous catheter infection and mycetoma of the leg in the USA and China, respectively.…”

Answer to July 2013 Photo Quiz

“…They are known to effectively protect plants against pathogens but proliferate on diseased or damaged tissue and are found in high numbers along with other epiphytic yeasts on wilting leaves. Two cases of human P. aphidis infections have been published, involving a patient with a central venous catheter infection and one with a mycetoma (3,4). Although the pathogenicity of this yeast is unclear, the patient with the central catheter infection had persistent fevers that did not subside until antifungal treatment was given (3).…”