Secondary Intracerebral Blastomycosis with Giant Yeast Forms

Wu, Shoujin; Vályi-Nagy, Tibor; Engelhard, Herbert H.; Anhthu, Mary; Janda, William M.

doi:10.1007/s11046-005-0147-6

Cited by 9 publications

(3 citation statements)

References 19 publications

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“…3). Wu et al (2005) reviewed five cases of blastomycosis that presented histopathologically with very large budding cells (20-40 lm diam). Paracoccidioides brasiliensis appears as spherical budding cells with multiple buds; younger cells measure 2-10 lm in diam, and mature cells often [ 30 lm, or even reach 60 lm in diam (Brummer et al 1993).…”

Section: Discussionmentioning

confidence: 99%

Phylogeny, ecology and taxonomy of systemic pathogens and their relatives in Ajellomycetaceae (Onygenales): Blastomyces, Emergomyces, Emmonsia, Emmonsiellopsis

et al. 2018

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The family Ajellomycetaceae (Onygenales) includes mammal-associated pathogens within the genera Blastomyces, Emmonsia, Histoplasma and Paracoccidioides, as well as the recently described genera, Emergomyces that causes disease in immunocompromised hosts, and Emmonsiellopsis, known only from soil. To further assess the phylogenetic relationships among and between members of these genera and several previously undescribed species, we sequenced and analyzed the DNA-directed RNA polymerase II (rPB2), translation elongation factor 3-a (TEF3), b-tubulin (TUB2), 28S large subunit rDNA (LSU) and the internal transcribed spacer regions (ITS) in 68 strains, in addition to morphological and physiological investigations. To better understand the thermal dimorphism among these fungi, the dynamic process of transformation from mycelial to yeast-like or adiaspore-like forms was also assessed over a range of temperatures (6-42°C). Molecular data resolved the relationships and recognized five major well-supported lineages that correspond largely to the genus level. Emmonsia, typified by Emmonsia parva, is a synonym of Blastomyces that also accommodates Blastomyces helicus (formerly Emmonsia helica). Emmonsia crescens is phylogenetically distinct, and found closely related to a single strain from soil without known etiology. Blastomyces silverae, Emergomyces canadensis, Emergomyces europaeus and Emmonsia sola are newly described. Almost all of the taxa are associated with human and animal disease. Emmonsia crescens, B. dermatitidis and B. parvus are prevalently associated with pulmonary disease in humans or animals. Blastomyces helicus, B. percursus, Emergomyces africanus, Es. canadensis, Es. europaeus, Es. orientalis and Es. pasteurianus (formerly Emmonsia pasteuriana) are predominantly found in human hosts with immune disorders; no animal hosts are known for these species except B. helicus.

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Section: Discussionmentioning

confidence: 99%

Phylogeny, ecology and taxonomy of systemic pathogens and their relatives in Ajellomycetaceae (Onygenales): Blastomyces, Emergomyces, Emmonsia, Emmonsiellopsis

et al. 2018

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“…Blastomyces yeast is typically described as broad-based budding, and it is 8–20 µM in diameter with a doubly refractile cell wall [ 87 ]. Interestingly, giant forms have been described occasionally that may be confused with Coccidioides [ 88 ]. Stains such as Gomori methenamine silver, calcofluor white, periodic acid–Schiff, and 10% potassium hydroxide are commonly used to visualize Blastomyces yeast [ 47 , 89 , 90 ].…”

Section: Diagnosismentioning

confidence: 99%

Blastomycosis—Some Progress but Still Much to Learn

Pullen

Alpern

Bahr

2022

JoF

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Blastomycosis, caused by Blastomyces spp., is an endemic mycosis capable of causing significant disease throughout the body. Higher rates of infection are seen in the Mississippi and Ohio River valleys, the Great Lakes region of the United States and Canada, much of Africa, and, to a lesser extent, in India and the Middle East. Limited reporting inhibits our true understanding of the geographic distribution of blastomycosis. An estimated 50% of those infected remain asymptomatic. Of those who present with symptomatic disease, pulmonary involvement is most common, while the most common extrapulmonary sites are the skin, bones, genitourinary system, and central nervous system. Itraconazole is the standard therapy for mild–moderate disease. Data for other azoles are limited. Amphotericin is used for severe disease, and corticosteroids are occasionally used in severe disease, but evidence for this practice is limited. Despite increasing incidence and geographic reach in recent years, there are still significant knowledge gaps in our understanding of blastomycosis. Here, we provide an updated review of the epidemiology, clinical presentations, and diagnostic and therapeutic approaches for this infection. We also discuss areas needing further research.

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“…2 While this appearance is unique among dimorphic fungi, giant forms (28 to 40 μm diameter) have been described and can be confused with Coccidioides species. 3 The mycelial form is characterized by septate hyphae (1 to 2 μm diameter) that produce asexual spores (4 to 5 μm diameter). 2 In contrast to the yeast, hyphal morphology is not distinct and requires molecular confirmation or transition to yeast for identification.…”

Section: Mycologymentioning

confidence: 99%

Clinical Manifestations and Treatment of Blastomycosis

McBride

Gauthier

Klein

2017

Clinics in Chest Medicine

159

230

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Synopsis The etiologic agents of blastomycosis, Blastomyces dermatitidis and B. gilchristii, belong to a group of thermally dimorphic fungi that can infect healthy and immunocompromised individuals. Following inhalation of mycelial fragments and spores into the lungs, Blastomyces spp. convert into pathogenic yeast, which facilitates evasion of host immune defenses to cause pneumonia and disseminated disease. The clinical spectrum of pulmonary blastomycosis is diverse, ranging from subclinical infection, acute pneumonia resembling bacterial community-acquired pneumonia, chronic pneumonia mimicking tuberculosis or malignancy, and acute respiratory distress syndrome. The diagnosis of blastomycosis requires a high-degree of clinical suspicion and involves the use of culture and non-culture-based fungal diagnostic tests. The site and severity of infection, and the presence of underlying immunosuppression or pregnancy influence selection of antifungal therapy.

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Secondary Intracerebral Blastomycosis with Giant Yeast Forms

Cited by 9 publications

References 19 publications

Phylogeny, ecology and taxonomy of systemic pathogens and their relatives in Ajellomycetaceae (Onygenales): Blastomyces, Emergomyces, Emmonsia, Emmonsiellopsis

Phylogeny, ecology and taxonomy of systemic pathogens and their relatives in Ajellomycetaceae (Onygenales): Blastomyces, Emergomyces, Emmonsia, Emmonsiellopsis

Blastomycosis—Some Progress but Still Much to Learn

Clinical Manifestations and Treatment of Blastomycosis

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