Molecular Epidemiology of Blastomyces dermatitidis

McCullough, Michael; DiSalvo, Arthur F.; Clemons, Karl V.; Park, Pilsang; Stevens, David A.

doi:10.1086/313649

Cited by 71 publications

(51 citation statements)

References 24 publications

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“…During investigation of another epidemic, this group again isolated the fungus from environmental sources (66). It is noteworthy that a subsequent study that examined a geographically diverse collection of B. dermatitidis isolates with a typing system based on PCR found that the soil isolates from Eagle River were different from the strains that caused the majority of cases (81). Nevertheless, evidence suggests that the ecological niche for B. dermatitidis is wet earth that has been enriched with animal droppings, rotting wood, and other decaying vegetable matter.…”

Section: Epidemiology and Ecology Of B Dermatitidismentioning

confidence: 99%

Clinical and Laboratory Update on Blastomycosis

2010

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SUMMARY Blastomycosis is endemic in regions of North America that border the Great Lakes and the St. Lawrence River, as well as in the Mississippi River and Ohio River basins. Men are affected more often than women and children because men are more likely to participate in activities that put them at risk for exposure to Blastomyces dermatitidis. Human infection occurs when soil containing microfoci of mycelia is disturbed and airborne conidia are inhaled. If natural defenses in the alveoli fail to contain the infection, lymphohematogenous dissemination ensues. Normal host responses generate a characteristic pyogranulomatous reaction. The most common sites of clinical disease are the lung and skin; osseous, genitourinary, and central nervous system manifestations follow in decreasing order of frequency. Blastomycosis is one of the great mimickers in medicine; verrucous cutaneous blastomycosis resembles malignancy, and mass-like lung opacities due to B. dermatitidis often are confused with cancer. Blastomycosis may be clinically indistinguishable from tuberculosis. Diagnosis is based on culture and direct visualization of round, multinucleated yeast forms that produce daughter cells from a single broad-based bud. Although a long course of amphotericin B is usually curative, itraconazole is also highly effective and is the mainstay of therapy for most patients with blastomycosis.

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Section: Epidemiology and Ecology Of B Dermatitidismentioning

confidence: 99%

Clinical and Laboratory Update on Blastomycosis

2010

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“…Alternatively, some isolates were cultured on Sabouraud dextrose agar (SDA) slants at 35°C and the DNA was extracted by initial cell disruption with glass beads (425 to 600 m, acid washed) (Sigma, St. Louis, MO) in a solution of 1 M sorbitol and 125 mM EDTA (45).…”

Section: Isolatesmentioning

confidence: 99%

Analysis of Inteins in the Candida parapsilosis Complex for Simple and Accurate Species Identification

et al. 2013

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cInteins are coding sequences that are transcribed and translated with flanking sequences and then are excised by an autocatalytic process. There are two types of inteins in fungi, mini-inteins and full-length inteins, both of which present a splicing domain containing well-conserved amino acid sequences. Full-length inteins also present a homing endonuclease domain that makes the intein a mobile genetic element. These parasitic genetic elements are located in highly conserved genes and may allow for the differentiation of closely related species of the Candida parapsilosis (psilosis) complex. The correct identification of the three psilosis complex species C. parapsilosis, Candida metapsilosis, and Candida orthopsilosis is very important in the clinical setting for improving antifungal therapy and patient care. In this work, we analyzed inteins that are present in the vacuolar ATPase gene VMA and in the threonyl-tRNA synthetase gene ThrRS in 85 strains of the Candida psilosis complex (46 C. parapsilosis, 17 C. metapsilosis, and 22 C. orthopsilosis). Here, we describe an accessible and accurate technique based on a single PCR that is able to differentiate the psilosis complex based on the VMA intein. Although the ThrRS intein does not distinguish the three species of the psilosis complex by PCR product size, it can differentiate them by sequencing and phylogenetic analysis. Furthermore, this intein is unusually present as both mini-and full-length forms in C. orthopsilosis. Additional population studies should be performed to address whether this represents a common intraspecific variability or the presence of subspecies within C. orthopsilosis.

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“…Furthermore, other groups have failed to find genotypic differences between the two strains. More study is required before conclusions may be made on genetic differences between the two strains (11). Clinical differences between the African and North American isolates were noted.…”

Section: Discussionmentioning

confidence: 99%

Blastomycosis in a Young African Man Presenting with a Pleural Effusion

Alvarez

Burns²,

Desjardins³

et al. 2006

Canadian Respiratory Journal

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in a young African man presenting with a pleural effusion. Can Respir J 2006;13(8):441-444.Blastomyces dermatitidis is a dimorphic fungus endemic to northwestern Ontario, Manitoba and some parts of the United States. The fungus is also endemic to parts of Africa. Pulmonary and extrapulmonary findings of a 24-year-old African man who presented with weight loss, dry cough and chronic pneumonia not resolving with antibiotic treatment are presented. The unusual occurrence of pulmonary blastomycosis associated with skin lesions and a moderate pleural effusion is reported. CASE PRESENTATIONA 24-year-old previously healthy man from Tanzania presented with a three-month history of dry cough, fatigue and fever. He was treated empirically for a community-acquired pneumonia; however, after two courses of antibiotic treatment he did not improve clinically, and had a worsening chest radiograph showing a large unilateral pleural effusion. His vital signs, however, were normal. Other clinical features included a 14 kg weight loss and scaling papulonodular skin lesions on the nose ( Figure 1A), right hand ( Figure 1B) and right forearm. In addition to the skin lesions, he also had a raised subcutaneous nodular lesion on his left buttock and left upper arm suppuration. InvestigationsOn admission, the patient's white blood cell count was 13.5×10 9 /L, hemoglobin level was 117 g/L, platelet count was 584×10 9 /L and serum albumin level was 30 g/L. Electrolytes, renal function and liver enzyme levels were normal. HIV serology was negative. Sputum initially showed heavy growth of normal respiratory flora; no acid-fast bacilli were seen. A pigtail catheter was inserted to drain the right pleural fluid which showed a pH of 8, glucose level of 5.6 mmol/L, total protein concentration of 62 g/L and lactate dehydrogenase level of 152 U/L. Pleural fluid white blood cell differential showed 31% neutrophils, 61% lymphocytes, 7% monocytes and 1% eosinophils. The pleural fluid was consistent with an exudate. Bronchoscopy washings were negative for Gram and fungal stains. Radiographs of the pelvis and femur were normal. A plain chest radiograph showed a moderate-sized right pleural effusion on posteroanterior view (Figure 2A) and some ill-defined soft tissue nodules in the lateral aspect of the left upper lung zone. An enhanced axial computed tomography of the thorax in the mediastinal window settings confirmed a moderate-sized right pleural effusion with multiple well-defined soft tissue nodules over the parietal pleura projecting into the pleural cavity, which was better seen over the diaphragmatic surface ( Figure 2B). No significant mediastinal lymphadenopathy was noted. On the lung window settings, centrilobular nodules in a tree-in-bud pattern at the apicoposterior segment of the left upper lobe were present. Consolidative changes of the lateral segment of the right middle lobe and the right lower lobe were also seen. Hospital courseThe patient was from an area endemic for HIV and tuberculosis, and had significant weight loss, mild anem...

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Molecular Epidemiology of Blastomyces dermatitidis

Cited by 71 publications

References 24 publications

Clinical and Laboratory Update on Blastomycosis

Clinical and Laboratory Update on Blastomycosis

Analysis of Inteins in the Candida parapsilosis Complex for Simple and Accurate Species Identification

Blastomycosis in a Young African Man Presenting with a Pleural Effusion

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