Phaeohyphomycosis caused by <i>Medicopsis romeroi </i>in solid organ transplant recipients: Report of two cases and comprehensive review of the literature

Los‐Arcos, Ibai; Royuela, Meritxell; Martín-Gómez, María Teresa; Alastruey‐Izquierdo, Ana; Sellarès, Joana; Perelló, Manel; Castells, L.; Dopazo, Cristina; Gavaldá, Joan; Len, Óscar

doi:10.1111/tid.13072

Cited by 11 publications

(8 citation statements)

References 23 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The pathogens differ in susceptibility to antifungal agents, as well as in their epidemiology [12,14]. For example, in Pleosporales, Medicopsis romeroi showed low susceptibility to several antifungal agents including amphotericin B, fluconazole, itraconazole and caspofungin [14,15,16]. In addition, differences are noted between the closely interrelated species of Madurella in their susceptibility to the main drug used for treating eumycetoma, itraconazole.…”

Section: Introductionmentioning

confidence: 99%

The genus Madurella: Molecular identification and epidemiology in Sudan

et al. 2020

View full text Add to dashboard Cite

Eumycetoma (mycotic mycetoma) is the fungal form of mycetoma, a subcutaneous infection occurring in individuals living in endemic areas of the disease. The Sudan is hyperendemic for mycetoma, with the highest incidence being reported from Gezira State, Central Sudan. The present study was conducted at the Gezira Mycetoma Center and aimed to determine the cause of black-grain eumycetoma in the state and describe its epidemiology. Blackgrain specimens were collected during the surgical operation and direct detection of the causative agent was performed using M. mycetomatis species-specific PCR and ITS PCR followed by sequencing. Black-grain was reported from 93.3% of all confirmed mycetoma cases (n = 111/119), with a prevalence in young males. Of the 91 samples subjected to direct PCR, 90.1% (n = 82) gave positive results. The predominant species (88.2%) was Madurella mycetomatis. One sample was identified as M. fahalii, one as M. tropicana, and one matched the phytopathogenic species Sphaerulina rhododendricola. The highest endemic zones were Southern Gezira (76.6%) and Northern Sinnar (23.4%). The study confirmed that direct molecular detection on grains provides rapid and specific diagnosis of agents of eumycetoma.

show abstract

Section: Introductionmentioning

confidence: 99%

The genus Madurella: Molecular identification and epidemiology in Sudan

et al. 2020

View full text Add to dashboard Cite

show abstract

“…As a result, we reviewed 228 published reports. We identified and included 149 reports on 201 cases of dematiaceous fungal infections in SOT recipients 21–169 . The majority (134/149; 90%) of included reports scored ≥ 2 of three possible points on our bias assessment (Table S4).…”

Section: Resultsmentioning

confidence: 99%

Dematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta‐analysis

Radcliffe

Azar

et al. 2022

Transplant Infectious Dis

View full text Add to dashboard Cite

Background: Dematiaceous fungi cause a number of infectious syndromes referred to as phaeohyphomycosis among both immunocompetent and immunocompromised hosts. We performed a systematic review to characterize these infections in solid organ transplant recipients (SOTR). Methods:We searched PubMed database (last searched 1/6/2022) for Englishlanguage reports on dematiaceous fungal infections in SOTR. Included reports needed individualized demographic, treatment, and outcome data; pediatric reports were excluded. A universally applicable bias assessment was performed on reports. Models for infection type and outcome were created using the Bayesian paradigm. Results:We included 149 reports on 201 cases of dematiaceous fungal infections in SOTR. The mean age was 54 years, 72% were men, and kidney recipients accounted for 61% of cases. Skin and soft tissue infection (SSTI) was the most common infectious syndrome (73%). Death from infection occurred in 7% of cases (14/201), with disseminated (32%) cases having the highest mortality. Our model for infection type predicted the relative probability of central nervous system infection to be highest in liver recipients. Across all transplant types, higher relative probabilities of disseminated and pulmonary infections occur in the early post-transplant period, and the predicted probabilities for these infection types decreased after 100 months post-transplantation.Discussion: We identified SSTI as the most common dematiaceous fungal infections in SOTR. Disseminated infections carried the worst prognosis. The evidence in this review is limited by the heterogeneity of included cases. No funding source was used, and this review's protocol was not registered.

show abstract

“…28 Itraconazole, which our patient received first, is not expected to have as reliable activity against Medicopsis. 5,9,17,28 Surgical excision of infected tissue also seems an important approach to clearing Medicopsis infections.…”

Section: Discussion and Review Of Literaturementioning

confidence: 99%

“…When its spores are introduced into cutaneous and subcutaneous tissue through trauma, they may cause immediate infection or may remain dormant until immunosuppression allows infection to emerge. 4,5 Most M. romeroi infections manifest as subcutaneous nodules and cysts on the limbs and extremities. Here, we report a case of a 64-year old man with post-traumatic M. romeroi endophthalmitis and summarize the literature on infections caused by this rare pathogen.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Posttraumatic Endophthalmitis Caused by Medicopsis romeroi

Garofalo

Wilcock²,

Lahey

2022

Infect Dis Clin Pract

View full text Add to dashboard Cite

Fungal exogenous endophthalmitis is rare. Here, we report a case of posttraumatic endophthalmitis caused by Medicopsis romeroi in a 64-year old man. After a tree branch punctured his right eye while hiking in Laos, the patient's symptoms included pain, blurry vision, limited vision of light and dark, and sensation of a foreign body. The patient was unsuccessfully treated in Thailand with itraconazole and intraocular amphotericin. Upon return to the United States, the patient underwent extensive ophthalmic surgery and voriconazole was prescribed. Fundoscopic examination showed resolution of inflammation 3 months after the surgery, but despite symptomatic improvement, severe visual deficits remained. We performed a comprehensive case review of reported cases of M. romeroi infection, revealing that M. romeroi commonly manifests as a subcutaneous infection on the extremities in immunosuppressed patients who usually resolved with antifungal and surgical therapy. Many patients living in temperate climates were reported to have a travel and/or an immigration pattern from a tropical zone. This case and review extend the clinical spectrum of Medicopsis to include ocular infections, illustrates the importance of considering rare pathogens in patients with exogenous endophthalmitis, and encourages prompt medical and surgical treatment of Medicopsis.

show abstract

Phaeohyphomycosis caused by Medicopsis romeroi in solid organ transplant recipients: Report of two cases and comprehensive review of the literature

Cited by 11 publications

References 23 publications

The genus Madurella: Molecular identification and epidemiology in Sudan

The genus Madurella: Molecular identification and epidemiology in Sudan

Dematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta‐analysis

Posttraumatic Endophthalmitis Caused by Medicopsis romeroi

Contact Info

Product

Resources

About