Revista Iberoamericana De Micologia最新文献

{"title":"Fungemia due to opportunistic fungi in patients with cancer.","authors":"Rodrigo M Flores-Delgado, Patricia Volkow, Consuelo Velázquez-Acosta, Patricia Cornejo-Juárez","doi":"10.1016/j.riam.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.riam.2024.01.001","url":null,"abstract":"<p><strong>Background: </strong>Fungemia due to uncommon fungi and secondary to multiple risk factors has become an emergent health problem, particularly in oncology patients.</p><p><strong>Aims: </strong>This study shows the following data collected during an 11-year period in a tertiary care oncologic center from patients with fungemia: demographic data, clinical characteristics, and outcome.</p><p><strong>Methods: </strong>A retrospective study was performed at Instituto Nacional de Cancerología, a 135-bed referral cancer center in Mexico City, from July 2012 to June 2023. All episodes of non-Candida fungemia were included.</p><p><strong>Results: </strong>Sixteen cases with uncommon fungemia were found in the database, representing 0.3% from all the blood cultures positive during the study period, and 8.5% from all the fungi isolated. The most common pathogens identified in our series were Histoplasma capsulatum, Acremonium spp., Trichosporon asahii, and Saccharomyces cerevisiae. Eight patients had hematologic malignancies, and five had severe neutropenia. In eight cases fungemia was considered catheter-related, in four cases was classified as primary, and in the last four it was diagnosed as disseminated fungal diseases. Mortality at 30 days was 43.8%.</p><p><strong>Conclusions: </strong>The improved diagnostic tools have led to a better diagnosis of uncommon fungal infections. More aggressive therapeutic approaches, particularly in patients with malignancies, would increase survival rates in these potentially fatal diseases.</p>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical response to prednisone in a severe case of infant-juvenile paracoccidioidomycosis.","authors":"Armando Guevara, Nathan Pereira Siqueira, Ronaldo Pereira de Sousa, Thiago Braga Dos Santos, Sandra Breder Assis, Zoilo Pires de Camargo, Anderson Messias Rodrigues, Ferry Hagen, Rosane Christine Hahn","doi":"10.1016/j.riam.2024.04.001","DOIUrl":"https://doi.org/10.1016/j.riam.2024.04.001","url":null,"abstract":"<p><strong>Background: </strong>Paracoccidioidomycosis is a neglected tropical disease caused by fungi of the genus Paracoccidioides. A wide range of symptoms is related to the disease; however, lungs and skin are the sites predominantly affected. The disease is mostly seen in people living in rural areas in Latin America.</p><p><strong>Case report: </strong>We present a pediatric case of severe disseminated paracoccidioidomycosis that slowly responded to the antifungal treatment. Within three months, symptoms evolved into hepatosplenomegaly, necrotic cervical and abdominal lymph nodes, and splenic abscess. Clinical response to amphotericin B deoxycholate and itraconazole was slow, resulting in pleural and peritoneal cavity effusions, heart failure and shock. Amphotericin B deoxycholate was replaced by the liposomal formulation, with no response. Subsequently, prednisone was added to the treatment, which led to improvement in the clinical response. Serological Paracoccidioides antibody titers were atypical, with very low titers in the critical phase and significant increase during the convalescence phase. The infection was finally cleared up with amphotericin B deoxycholate, liposomal amphotericin B and the use of corticosteroids. Paracoccidioidomycosis serology was non-reactive two years post-discharge.</p><p><strong>Conclusions: </strong>Due to the intense inflammatory response triggered by Paracoccidioides cells, giving low-dose prednisone for a short period of time modulated the inflammatory response and supported antifungal treatment.</p>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scedosporium boydii finding in an immunocompromised patient and review of the literature.","authors":"Silvana Ramadán, Hernán Dalmaso, Alicia Luque, Maximiliano Sortino, María Luján Cuestas, Katherine Hermida Alava, Diego Bertola, Lucía Bulacio","doi":"10.1016/j.riam.2023.10.001","DOIUrl":"10.1016/j.riam.2023.10.001","url":null,"abstract":"<p><strong>Background: </strong>Scedosporiasis is an emerging mycosis that has gained importance in recent years due to its worldwide prevalence. It is caused by species of the Scedosporium apiospermum complex. These species can cause opportunistic infections in immunocompromised patients and, occasionally, in immunocompetent patients as well. The high intrinsic antifungal resistance make these infections difficult to manage.</p><p><strong>Aims: </strong>The objective of this study was to interpret the mycological findings in a transplant patient, together with the images obtained in the radiological studies, in order to provide an early and effective antifungal therapy.</p><p><strong>Methods: </strong>The mycological analysis of samples taken from a heart transplant patient with radiological images suggesting a fungal infection was performed. Computed tomography scan of the head and thorax showed space-occupying lesions in both the frontal lobe and cerebellum, and multiple pulmonary nodules. The nodules were punctured and the samples obtained were analyzed according to the procedures for mycological analysis. The identity of the isolates was confirmed by nucleotide sequencing. Eventually, the antifungal susceptibility was studied.</p><p><strong>Results: </strong>The fungal isolates obtained, whose identity was confirmed by sequencing, belonged to the species Scedosporium boydii. Injured tissues were surgically removed and a treatment with amphotericin B and voriconazole-minimum inhibitory concentration (MIC) 0.5μg/mL and ≥0.5μg/mL respectively - was administered.</p><p><strong>Conclusions: </strong>Although the patient died due to complications of a Klebsiella pneumoniae sepsis refractory to treatment, the progression of the fungal disease, although slow, was favourable in the early phases of the treatment due to a correct diagnosis and the antifungal susceptibility test carried out. Clinical cases of this nature highlight the need to increase the epidemiological study of these microorganisms, as well as the proper treatment of the diseases caused, in order to achieve early diagnoses that reduce the morbidity and mortality of patients.</p>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolation of filamentous basidiomycetes from respiratory samples in a tertiary care Spanish hospital.","authors":"Iker Falces-Romero, Inmaculada Quiles-Melero, Julio García-Rodríguez","doi":"10.1016/j.riam.2023.11.001","DOIUrl":"10.1016/j.riam.2023.11.001","url":null,"abstract":"<p><strong>Background: </strong>The clinical significance of the filamentous basidiomycetes isolated from clinical samples is not always clear. Thus, these fungi have been considered environmental contaminants traditionally.</p><p><strong>Aims: </strong>To review those clinical cases in which filamentous basidiomycetes from respiratory samples had been isolated.</p><p><strong>Methods: </strong>The retrospective study was carried out in a single tertiary care hospital. We recovered all culture-confirmed isolations of filamentous basidiomycetes from respiratory samples (bronchial aspirate [BAS], bronchoalveolar lavage [BAL] and sputum) analyzed between the years 2020 and 2023. Isolates were identified by ITS region sequencing.</p><p><strong>Results: </strong>In six patients a filamentous basidiomycete had been isolated from a respiratory sample. The species identified were all different: Fomitopsis sp. (BAS), Trametes ljubarskyi (BAL), Stereum gausapatum (BAS), Porostereum spadiaceum (BAS), Phlebia subserialis (sputum) and Inonotus levis (BAL). All the patients were immunosuppressed or had an underlying disease with pulmonary involvement. None of them received any specific antifungal treatment (in relation with the fungus isolated) and all six improved clinically and were discharged.</p><p><strong>Conclusions: </strong>The isolation of filamentous basidiomycetes in these patients had uncertain clinical significance. However, the isolation of any filamentous basidiomycete in respiratory samples from immunosuppressed patients or patients with chronic pulmonary disease is an emerging situation that should be carefully assessed in the context of chronic allergic episodes or suspicion of invasive fungal infections.</p>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The number of species that cause blastomycosis is increasing","authors":"F. Javier Cabañes","doi":"10.1016/j.riam.2022.07.001","DOIUrl":"10.1016/j.riam.2022.07.001","url":null,"abstract":"","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1130140622000316/pdfft?md5=f9dd7e2eb663f818949f544a68ce52b2&pid=1-s2.0-S1130140622000316-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40453222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Problemas clínicos en Micología Médica: problema número 56","authors":"Fernando Messina ,&nbsp;Emmanuel Marin ,&nbsp;Alejandro Sansostera ,&nbsp;Mercedes Romero ,&nbsp;Roxana Depardo ,&nbsp;Ricardo Negroni ,&nbsp;Blanca Leonel ,&nbsp;Gabriela Santiso","doi":"10.1016/j.riam.2022.12.001","DOIUrl":"10.1016/j.riam.2022.12.001","url":null,"abstract":"<div><p>We present the case of a twenty six year-old woman with rheumatoid arthritis, treated with certolizumab. She sought medical attention due to cough, fever and night sweats. X-ray exam showed a miliary pneumonia. She was treated for tuberculosis and 50<!--> <!-->days later she presented with aphasia. Magnetic nuclear resonance revealed brain lesions. <em>Histoplasma capsulatum</em> PCR test and urinary antigen were positive, so an antifungal treatment with voriconazole was started. Visual adverse effects forced to change the antifungal schedule in both the length of treatment and the antifungal drug. With this measure the patient progressed favorably. The test of urinary <em>Histoplasma capsulatum</em> antigen and PCR amplification were key to make a diagnosis and also for a follow-up.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrotizing pneumonia due to Aspergillus and Salmonella after immune checkpoint inhibitor treatment: An unusual case and review of the literature","authors":"Muhammed Cihan Işık ,&nbsp;Oğuz Karcıoğlu ,&nbsp;Gülşen Hazırolan ,&nbsp;Dolunay Gülmez ,&nbsp;Mehmet Ruhi Onur ,&nbsp;Mehmet Mahir Kunt ,&nbsp;Sevtap Arikan-Akdagli ,&nbsp;Gökhan Metan","doi":"10.1016/j.riam.2023.05.001","DOIUrl":"10.1016/j.riam.2023.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Immune checkpoint inhibitors (ICIs) are a promising new treatment for different types of cancer. The infectious complications in patients taking ICIs are rare.</p></div><div><h3>Case report</h3><p><span>A 58-year-old male who received chemotherapy consisting of pembrolizumab (PD-1 inhibitor) for esophagus squamous cell carcinoma one month before was admitted to the emergency room with shortness of breath soon after fiberoptic bronchoscopy, which was done for the inspection of the lower airway. A computed tomography of the chest revealed a progressive consolidation on the right upper lobe. </span><em>Salmonella</em> group D was isolated from the bronchoalveolar lavage (BAL) fluid culture. The fungal culture of the same clinical sample yielded <span><span>Aspergillus niger</span></span>; furthermore, a high titer (above the cut-off values) of <em>Aspergillus</em> antigen was found both in the BAL fluid and serum of the patient. Despite the effective spectrum and appropriate dose of antimicrobial treatment, the patient died due to disseminated intravascular coagulopathy.</p></div><div><h3>Conclusions</h3><p>Awareness of unusual pathogens in the etiology of pneumonia after ICI treatment may help to avoid underdiagnosis.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10265611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endocarditis due to Candida albicans in an immunocompromised patient: A case report","authors":"José J. Flores-Patiño ,&nbsp;Mikel J. Durán-Pacheco ,&nbsp;Alondra M. Cázares-Marroquín ,&nbsp;José M. Gastélum-Cano ,&nbsp;María A. Islas-Osuna ,&nbsp;José A. Arízaga-Berber","doi":"10.1016/j.riam.2023.06.001","DOIUrl":"10.1016/j.riam.2023.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Fungal endocarditis is a low-frequency disease with a challenging diagnosis, as it can be mistaken with bacterial endocarditis. Fungal endocarditis causes higher mortality rates in immunocompromised patients. In the clinical practice, the endocarditis caused by fungi represents up to 10% of all infectious endocarditis cases and has a mortality rate of nearly 50%.</p></div><div><h3>Case report</h3><p>Here we present the case of a 53-year-old woman under corticosteroid therapy with a history of rheumatic heart disease, aortic valve replacement, and rheumatoid arthritis, who presented with fungal endocarditis caused by <span><em>Candida albicans</em></span>. Even though the patient received 3 years of antifungal prophylaxis with fluconazole, had valve replacement surgery, and received intensive care, the patient finally worsened and died.</p></div><div><h3>Conclusions</h3><p>Comorbidities and corticosteroid therapy predisposed the patient to acquire fungal endocarditis. This case highlights the importance of implementing procedures for the isolation and identification of fungi, and for carrying out antifungal-susceptibility testing, as well as establishing surveillance programs to identify infection-causing species and drug resistance patterns in hospitals. Moreover, designing and upgrading the algorithm for infectious endocarditis is the key to future improvements in diagnosis.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41109919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the MALDI-TOF mass spectrometry technique for the identification of dermatophytes: Use of an extended database","authors":"Ivana Maldonado ,&nbsp;Silvia Relloso ,&nbsp;Liliana Guelfand ,&nbsp;Bárbara Fox ,&nbsp;Natalia Azula ,&nbsp;Vanesa Romano ,&nbsp;Agostina Cantore ,&nbsp;Rubén Barrios ,&nbsp;Susana Carnovale ,&nbsp;Ezequiel Nuske ,&nbsp;Patricia Minervini ,&nbsp;members of the Red de Micología de la Ciudad Autónoma de Buenos Aires [Mycology Network of the Autonomous City of Buenos Aires] (RMCABA)","doi":"10.1016/j.riam.2021.01.006","DOIUrl":"10.1016/j.riam.2021.01.006","url":null,"abstract":"<div><h3>Background</h3><p>Identification of dermatophytes is usually performed through morphological analyses. However, it may be hindered due to the discovery of new species and complexes and, with some isolates, by the absence of fructification. Matrix-assisted laser desorption/ionisation-time-of-flight mass spectrometry (MALDI-TOF MS) seems to be an option for improving identification.</p></div><div><h3>Aims</h3><p>To develop a database (DB) for the identification of dermatophytes with MALDI-TOF MS, including 32 isolates from the Red de Micología de la Ciudad Autónoma de Buenos Aires [Mycology Network of the Autonomous City of Buenos Aires] (RMCABA) and one reference isolate (RMCABA DB), and evaluate its performance when added to the DB from the supplier, Bruker (Bruker DB).</p></div><div><h3>Methods</h3><p>All the isolates in the RMCABA DB were identified based on morphology and sequencing. To evaluate the performance of the extended DB (Bruker DB plus RMCABA DB), 136 clinical isolates were included.</p></div><div><h3>Results</h3><p>The percentages of identification at the species level increased from 45% to 88%, but the identification at the genus level decreased from 23% to 7%.</p></div><div><h3>Conclusions</h3><p>MALDI-TOF MS yielded better performance in the identification of dermatophytes after including the RMCABA DB, which encompassed local isolates.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89719401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candida bloodstream infection in patients with cancer: A retrospective analysis of an 11-year period","authors":"Rodrigo Vázquez-Olvera ,&nbsp;Patricia Volkow ,&nbsp;Consuelo Velázquez-Acosta ,&nbsp;Patricia Cornejo-Juárez","doi":"10.1016/j.riam.2022.12.002","DOIUrl":"10.1016/j.riam.2022.12.002","url":null,"abstract":"<div><h3>Background</h3><p><em>Candida</em> bloodstream infection (CBSI) is a growing problem among patients with cancer.</p></div><div><h3>Aim</h3><p>To describe the main clinical and microbiological characteristics in patients with cancer who suffer CBSI.</p></div><div><h3>Methods</h3><p>We reviewed the clinical and microbiological characteristics of all patients with CBSI diagnosed between January 2010 and December 2020, at a tertiary-care oncological hospital. Analysis was done according to the <em>Candida</em> species found. Multivariate logistic regression analysis was used to determine the risk factors associated with 30-day mortality.</p></div><div><h3>Results</h3><p>There were 147 CBSIs diagnosed, 78 (53%) in patients with hematologic malignancies. The main <em>Candida</em> species identified were <span><em>Candida albicans</em></span> (<em>n</em> <!-->=<!--> <!-->54), <span><em>Candida glabrata</em></span> (<em>n</em> <!-->=<!--> <!-->40) and <span><em>Candida tropicalis</em></span> (<em>n</em> <!-->=<!--> <!-->29). <em>C. tropicalis</em> had been mainly isolated from patients with hematologic malignancies (79.3%) who had received chemotherapy recently (82.8%), and in patients with severe neutropenia (79.3%). Seventy-five (51%) patients died within the first 30 days, and the multivariate analysis showed the following risk factors: severe neutropenia, a Karnofsky Performance Scale score under 70, septic shock, and not receiving appropriate antifungal treatment.</p></div><div><h3>Conclusions</h3><p>Patients with cancer who develop CBSI had a high mortality related with factors associated with their malignancy. Starting an empirical antifungal therapy the soonest is essential to increase the survival in these patients.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9190997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}