Tibial Osteomyelitis Due to Fonsecaea pedrosoi in an Immunocompetent Patient: Case Report

Karuppal, Raju; Kumaran, Chathoth Meethal; Marthya, Anwar; Kumar, Chilambeth Veetil Manoj; Narayanan, Mini Palathingal; Raman, R.; Thomas, Sheila

doi:10.1053/j.jfas.2009.05.010

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…Other organisms associated with single case reports include P. obovatum, E. oligosperma, C. arxii, M. mycetomatis, P. richardsiae, F. pedrosoi, and P. parasiticum (94,390,398,472,512,689,812). Itraconazole was the most common single agent used with success (398,512,689).…”

Section: Phaeohyphomycosismentioning

confidence: 99%

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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: Phaeohyphomycosismentioning

confidence: 99%

“…Itraconazole was the most common single agent used with success (398,512,689). Antifungal therapy for all these cases is usually prolonged, i.e., Ͼ6 months and up to 2 years.…”

Section: Phaeohyphomycosismentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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“…10 The combination of surgical debridement and itraconazole therapy has been used to treat cases of F. pedrosoi osteomyelitis. 6,7 In a few reported cases, terbinafine was used at high dosage or combined with itraconazole to treat cases of chromoblastomycosis refractory to antifungal treatment. 11 The combination of terbinafine and voriconazole was synergistic in vitro on the Fonsecaea monophora strain of refractory chromoblastomycosis.…”

Section: Discussionmentioning

confidence: 99%

Arthrocladium fulminans Arthritis and Osteomyelitis

Diallo¹,

Michaud²,

Tabibou³

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. Arthrocladium fulminans is the only species in the Arthrocladium genus that has been involved in a previous human infection. To date, only one case of A. fulminans infection in a patient with GATA-2 immunodeficiency has been reported. We here report the second human case and the first case of septic arthritis and osteomyelitis due to A. fulminans in an immunocompetent patient, living in Mayotte, a French island in western Indian Ocean. He was successfully treated with surgical debridement and 6 months of antifungal treatment. This second observation of human invasive disease caused by A. fulminans is an additional argument for the pathogenicity of this rare species.

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“…Karuppal et al 10 have reported a 50-year-old immunocompetent male who had pain, swelling and multiple discharging sinuses on the left ankle for 3 years. Computed tomography imaging showed lytic areas on the left tibia.…”

Section: Discussionmentioning

confidence: 99%

Fonsecaea pedrosoi: A rare cause of dental infection and maxillary osteomyelitis in a child with acute lymphoblastic leukemia

et al. 2016

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SUMMARY: Tural-Kara T, Özdemir H, İnce E, İleri T, Çiftçi E. Fonsecaea pedrosoi: A rare cause of dental infection and maxillary osteomyelitis in a child with acute lymphoblastic leukemia. Turk J Pediatr 2016; 58: 679-682.Dental lesions are commonly seen in children with malignancy. We report a child with acute lymphoblastic leukemia who had black-brown dental lesion during the febrile neutropenic episode. Histopathological examination of dental lesion showed fungal hyphae and conidia. F. pedrosoi that was isolated from the tissue culture. The patient was treated with intravenous liposomal amphotericin B therapy for 5 weeks and he was discharged on oral voriconazole. On follow-up, clinical symptoms recovered. Although F. pedrosoi may be an unusual causative agent of dental infection and maxillary osteomyelitis, it should be considered in patient with black-brown lesions which do not respond to antibacterial treatment. Key words: acute lymphoblastic leukemia, children, dental infection, Fonsecaea pedrosoi, osteomyelitis.Patients with acute myeloid leukemia, relapsed leukemia, those receiving highly myelosuppressive chemotherapy and allogeneic hematopoietic stem cell transplant recipients have high risk for fungal infections. Even though invasive fungal infection related mortality can be reduced with prophylactic antifungal therapy, it still continues to be a major cause of morbidity and mortality in neutropenic patients 1 . The incidence of fungal infections in acute lymphoblastic leukemia (ALL) is reportedly 24% and it can increase with prolonged duration of neutropenia 2 . C h r o m o b l a s t o m y c o s i s p e r s e , i s a n infection of skin and subcutaneous tissue 3 .Chromoblastomycosis is a well-established disease caused by F. pedrosoi and have just a few case reports. However, F. pedrosoi associated dental infections and maxillary osteomyelitis have not been reported. To our knowledge, this is the first reported pediatric case of dental infection and maxillary osteomyelitis caused by F. pedrosoi. Case ReportA 6-year-old boy with a diagnosis of standard risk B precursor ALL presented with fever on the 43 rd day of delayed intensification therapy as per COG AALL0331 chemotherapy regimen. On physical examination, he was febrile and pale. His vital signs included a temperature of 39 ºC, heart rate of 128 beats per minute, respiratory rate of 32 breaths per minute, and a blood pressure of 86/52 mmHg. He had 3 cm hepatomegaly below the right costal margin and 2 cm splenomegaly below the left costal margin. The rest of physical examination was normal, and no infectious focus was detected. Patient's laboratory test results were as followed; hemoglobin 11.7 g/dl, white blood cell count 0.2x10 3 /mm 3 , absolute neutrophil count 0/mm 3 (neutrophils 0%, lymphocytes 90%, monocytes 4% and eosinophils 6%), platelet count 16x10 3 /mm 3 , C-reactive protein 62 mg/L. He was started on intravenous cefoperazone-sulbactam for fever and neutropenia. The following day, intravenous teicoplanin and acyclovir were

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Tibial Osteomyelitis Due to Fonsecaea pedrosoi in an Immunocompetent Patient: Case Report

Cited by 7 publications

References 11 publications

Melanized Fungi in Human Disease

Melanized Fungi in Human Disease

Arthrocladium fulminans Arthritis and Osteomyelitis

Fonsecaea pedrosoi: A rare cause of dental infection and maxillary osteomyelitis in a child with acute lymphoblastic leukemia

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