Phaeohyphomycosis of the nasal sinuses caused by Bipolaris species

Rao, A.V.; Forgan-Smith, Ross; Miller, Stephen M.; Haswell, Helen

doi:10.3109/00313028909061075

Cited by 10 publications

(8 citation statements)

References 5 publications

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“…These conidia have sympodial presentation and dark truncated hilum as in Bipolaris spicifera. 6,8 To confirm the species, 2 PCR of ITS-5,8S region of the ribosomal gene was extracted from the culture because of the similarity between the different moulds.…”

Section: Mycologymentioning

confidence: 99%

A pseudo tumoral sinusitis caused by Bipolaris sp.

Toul¹,

Castillo²,

Hofman³

et al. 2006

Journal of Infection

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Section: Mycologymentioning

confidence: 99%

A pseudo tumoral sinusitis caused by Bipolaris sp.

Toul¹,

Castillo²,

Hofman³

et al. 2006

Journal of Infection

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“…These vary from superficial skin infection to lethal cerebral disease (4,6,8). Several species of the dematiaceous fungi are neurotropic, i.e., have a predilection for central nervous system tissue, causing brain lesions and/or abscesses.…”

mentioning

confidence: 99%

SCH 56592, Amphotericin B, or Itraconazole Therapy of Experimental Murine Cerebral Phaeohyphomycosis Due to Ramichloridium obovoideum (“ Ramichloridium mackenziei ”)

Al-Abdely

Najvar

Bocanegra

et al. 2000

Antimicrob Agents Chemother

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Ramichloridium obovoideum ("Ramichloridium makenziei") is a rare cause of lethal cerebral phaeohyphomycosis. It has been, so far, geographically restricted to the Middle East. BALB/c mice were inoculated with two strains of R. obovoideum intracranially. Therapy with amphotericin B, itraconazole, or the investigational triazole SCH 56592 was conducted for 10 days. Half the mice were monitored for survival and half were killed for determination of the fungal load in brain tissue. Recipients of SCH 56592 had significantly prolonged survival and lower brain fungal burden, and this result was found for mice infected with both of the fungal strains tested. Itraconazole reduced the brain fungal load in mice infected with one strain but not the other, while amphotericin B had no effect on brain fungal concentrations. This study indicates a possible role of SCH 56592 in the treatment of the serious cerebral phaeohyphomycosis due to R. obovoideum.Dematiaceous fungi, the agents of phaeohyphomycosis, cause a variety of clinical syndromes (9). These vary from superficial skin infection to lethal cerebral disease (4,6,8). Several species of the dematiaceous fungi are neurotropic, i.e., have a predilection for central nervous system tissue, causing brain lesions and/or abscesses. These include Cladophialophora bantiana, Wangiella dermatitidis, Chaetomium spp., Exophiala spp., Curvularia spp., Bipolaris spp., and a few other species (1, 2, 4, 5).Ramichloridium obovoideum ("Ramichloridium mackenziei") is a rare cause of cerebral phaeohyphomycosis. It seems to be geographically restricted, as all cases have been reported from the Middle East or natives of the Middle East who lived in other countries (3,7,11). Reported cases have involved both immunocompromised and apparently immunocompetent patients. The infection was lethal for almost all patients with reported cases of infection, despite surgery and, in some cases, antifungal therapy. In the study described here we developed a murine model of infection with R. obovoideum and tested currently available (amphotericin B, itraconazole) and investigational (SCH 56592; Schering-Plough Research Institute Inc., Kenilworth, N.J.) antifungal agents in vitro and in an experimental murine model. MATERIALS AND METHODSPathogen. R. obovoideum ("R. mackenziei") 653 (gift from S. Al-Hedaithy, Riyadh, Saudi Arabia) and 95-1147 (Fungus Testing Laboratory, San Antonio, Tex.) were used for the in vitro testing and the experimental infection of BALB/c nu/ϩ mice. R. obovoideum 653 was also used to establish infection in ICR mice. R. obovoideum strains were grown on potato dextrose agar (PDA) medium plates (BBL, Baltimore Biologics, Cockeysville, Md.) for 14 days at 37°C. Surface growth was washed with sterile 0.85% normal saline and was filtered through layers of sterile glass wool. Homogeneous suspensions of the appropriate conidial concentration were prepared by using hemacytometer counts. The conidial suspension was administered in 0.2 ml for the intravenous inoculations and in 0.06 ml for the int...

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“…Bipolaris spicifera appears frequently in medical literature as a cause of diseases in humans and animals. Besides cutaneous and subcutaneous phaeohyphomycoses (15,31), a meningitis (12), fungemia in children infected with human immunodeficiency virus (32), disseminated infection (9), a mycotic keratitis (8), a fatal fungal endarteritis (21), and disseminated infection in a neonate (17), most of the cases where Bipolaris spicifera is involved are pertaining to the nasal sinuses (6,14,16,20,23,25,26,27,28,29,30). Interestingly, many of these cases were encountered in areas where a hot climate is predominant (Texas, South Carolina, Arizona, and Georgia in the United States; Brisbane, Australia; Pakistan; and India).…”

mentioning

confidence: 99%

Bipolaris spiciferaCauses Fungus Balls of the Sinuses and Triggers Polypoid Chronic Rhinosinusitis in an Immunocompetent Patient

et al. 2003

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We report the rare case of a 19-year-old immunocompetent male suffering both from fungus balls of the sinuses and from chronic rhinosinusitis with massive polyposis. Endoscopic sinus surgery revealed grayish brown necrotic masses embedded in viscous eosinophilic mucus. Inoculated onto petri dishes, these masses as well as the mucus grew a dark pigmented fungus, which was identified as Bipolaris spicifera. CASE REPORTA 19-year-old immunocompetent (human immunodeficiency virus negative, no evidence for malignancy) man was referred to our clinic because of restricted nasal breathing for 1 year and total nasal obstruction for more than 4 months. Computed tomography scan revealed massive sinusitis, with significant decalcification and destruction of the bone at skull base. Polyps and fungal masses had elevated the dura and extended far intracranially, especially in the frontal recess region and the roof of the anterior ethmoid. The dura appeared to be pushed against the brain for more than 1 cm on both sides (Fig. 1). On magnetic resonance imaging, however, there appeared to be no infiltration or penetration of the dura. Endoscopic examination showed a total obstruction of both nostrils with glassy polyps. Immunological examination of the patient's blood showed a highly elevated level of total immunoglobulin E (IgE) (4,446 kU per liter (kUL Ϫ1 ); normal value, Ͻ100 kUL Ϫ1 ). Specific IgE tests (UniCAP; Pharmacia, Uppsala, Sweden) yielded classes 3 and 4 for all fungal allergens tested ( ). Clinical chemistry showed no abnormalities in electrolytes, substrates, enzymes, and proteins, blood coagulation parameters were also in the normal range. The differential white blood cell count indicated significant eosinophilia (20% of leukocytes, 1 billion per liter); the basophil levels were also elevated slightly (1.6%).Endoscopic sinus surgery of both sides was performed by using VTI-Navigation (Visualization Technology, Inc./GE Medical Systems, Lawrence, Mass.). On the left side, the patient presented with a massive polyposis, with polyps protruding as far as the nasal vestibulum. Mucus masses were aspirated first and preserved for mycological examination. Then, in a stepwise fashion, the anteriormost polyps were removed until a huge mucocele of the concha bullosa of the middle turbinate was identified. This mucocele reached almost to the nasal vestibule and filled most of the nasal lumen. When opened there were massive polyps with glue-like mucus and fungal masses inside the concha. Then, in a stepwise fashion, preparation was taken further posteriorly and up, until in the posterior ethmoid skull base could be identified. Laterally, the polyps and fungal masses had protruded significantly (8 to 10 mm) toward the orbit; the bony border was missing partially. Only with navigational support was it possible to avoid all of the areas of hazard in this distorted anatomy. Removal of the glue-like inspissated material was extremely difficult and time-consuming. The sphenoid sinus was then identified and opened; it, too, was filled ...

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Phaeohyphomycosis of the nasal sinuses caused by Bipolaris species

Cited by 10 publications

References 5 publications

A pseudo tumoral sinusitis caused by Bipolaris sp.

A pseudo tumoral sinusitis caused by Bipolaris sp.

SCH 56592, Amphotericin B, or Itraconazole Therapy of Experimental Murine Cerebral Phaeohyphomycosis Due to Ramichloridium obovoideum (“ Ramichloridium mackenziei ”)

Bipolaris spiciferaCauses Fungus Balls of the Sinuses and Triggers Polypoid Chronic Rhinosinusitis in an Immunocompetent Patient

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