Phialophora richardsiae Infection in Humans

Pitrak, David; Koneman, Elmer W.; Estupinan, Robert C.; Jackson, Johnny

doi:10.1093/clinids/10.6.1195

Cited by 20 publications

(15 citation statements)

References 15 publications

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“…Clinically significant species in the mostly wood-inhabiting genus Pleurostomophora include P. richardsiae (obsolete Phialophora richardsiae) and P. repens (obsolete Phialophora repens), and individuals acquiring these mycoses are commonly immunocompromised (369,601,815). Species are anamorphs of the genus Pleurostoma.…”

Section: Sordarialesmentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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SUMMARY Melanized or dematiaceous fungi are associated with a wide variety of infectious syndromes. Many are soil organisms and are generally distributed worldwide, though certain species appear to have restricted geographic ranges. Though they are uncommon causes of disease, melanized fungi have been increasingly recognized as important pathogens, with most reports occurring in the past 20 years. The spectrum of diseases with which they are associated has also broadened and includes allergic disease, superficial and deep local infections, pneumonia, brain abscess, and disseminated infection. For some infections in immunocompetent individuals, such as allergic fungal sinusitis and brain abscess, they are among the most common etiologic fungi. Melanin is a likely virulence factor for these fungi. Diagnosis relies on careful microscopic and pathological examination, as well as clinical assessment of the patient, as these fungi are often considered contaminants. Therapy varies depending upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Triazoles such as voriconazole, posaconazole, and itraconazole have the most consistent in vitro activity. Further studies are needed to better understand the pathogenesis and optimal treatment of these uncommon infections.

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Section: Sordarialesmentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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“…Endophthalmitis due to dematiaceous fungi is uncommon with a generally poor prognosis [5–13]. Affected eyes typically have devastating visual loss and may ultimately require enucleation.…”

Section: Discussionmentioning

confidence: 99%

Dematiaceous fungal endophthalmitis: report of a case and review of the literature

Fox

Houser

Morris

et al. 2016

J Ophthal Inflamm Infect

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Background Pleurostomophora richardsiae (formerly Phialophora richardsiae) is a dematiaceous fungus that is an uncommon cause of ocular infection. Herein, we present a case of endogenous endophthalmitis associated with disseminated P. richardsiae infection.FindingsThis is a descriptive case report with a brief review of literature. A 43-year-old male admitted to the hospital following an acute cerebellar hemorrhage was found to have a swollen and tender wrist. The patient was afebrile with leukocytosis. Visual acuity was hand motion in the right eye and 20/20 in the left. Right eye examination noted anterior chamber cells and flare, vitreous haze and multiple large, and fluffy retinal infiltrates. Diagnostic vitrectomy revealed a mixed inflammatory cell infiltrate with numerous fungal elements. Blood cultures were negative, multiple transesophageal echocardiography studies revealed no vegetations, and synovial fluid aspiration of the wrist and biopsy of the radius were unremarkable. The patient was treated with intravitreal cefazolin, vancomycin, and amphotericin B, topical ciprofloxacin and natamycin, and intravenous amphotericin B and voriconazole. Visual acuity in the right eye declined to light perception, and examination revealed increasing anterior and posterior chamber inflammation. The patient died several weeks after presentation due to a massive intracranial hemorrhage. Fungal culture results from the vitrectomy were received post mortem and were positive for P. richardsiae.Conclusions P. richardsiae endophthalmitis is rare, and outcomes are typically poor. Infections typically occur following traumatic skin inoculation; however, a long refractory period may occur before symptoms develop. Early diagnosis and combination antimicrobial therapy are essential to optimize visual outcomes.

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“…Thus, our case is unique because the patient's chromoblastomycosis lesion was caused by a rarely isolated dematiaceous fungus, P. richardsiae. Invasive disease is unusual and occurs only in patients who are severely immunocompromised 13,15 . Conditions associated with deficient cell-mediated immunity appear to increase the risk of acquiring infection with P. richardsiae, but a normal host may also become infected as in our patient's case [13][14][15][16] .…”

Section: Discussionmentioning

confidence: 99%

“…It is a common contaminant of wood and is an industrial nuisance, causing bluing of wood pulp and paper 13,14 . P. richardsiae and other members of the genus Phialophora can cause disease in humans, most often manifested as an infectious subcutaneous granuloma or abscess 15,16 .…”

Section: Introductionmentioning

confidence: 99%

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Chromoblastomycosis Caused byPhialophora richardsiae

Son

Kang

et al. 2010

Ann Dermatol

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Chromoblastomycosis is a chronic fungal disease of the skin and subcutaneous tissues caused by a group of dematiaceous (black) fungi. The most common etiologic agents are Fonsecaea pedrosoi and Cladophialophora carrionii, both of which can be isolated from plant debris. The infection usually follows traumatic inoculation by a penetrating thorn or splinter wound. Several months after the injury, painless papules or nodules appear on the affected area; these papules then progress to scaly and verrucose plaques. We report a case of chromoblastomycosis caused by Phialophora richardsiae, which has been rarely associated with chromoblastomycosis. The case involved a 43-year-old male, who for the past 2 months had noted an erythematous, pustulous plaque that was somewhat dark brown in color on his right shin; the plaque also had intermittent purulent discharge and crust formation. On histopathological examination, chronic granulomatous inflammation and sclerotic cells were seen. The tissue fungus culture grew out the typical black fungi of P. richardsiae, which was confirmed by polymerase chain reaction. The patient has been treated with a combination of terbinafine and itraconazole for 3 months with a good clinical response. (Ann Dermatol 22(3) 362∼366, 2010)

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Phialophora richardsiae Infection in Humans

Cited by 20 publications

References 15 publications

Melanized Fungi in Human Disease

Melanized Fungi in Human Disease

Dematiaceous fungal endophthalmitis: report of a case and review of the literature

Chromoblastomycosis Caused byPhialophora richardsiae

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