{"title":"Morphological and Tinctorial Characteristics of Fungal Hyphae in Tissue.","authors":"Masatomo Kimura","doi":"10.3314/mmj.25.004","DOIUrl":"https://doi.org/10.3314/mmj.25.004","url":null,"abstract":"<p><p>Although culture remains the gold standard for detecting etiologic fungal organisms, histopathology plays a crucial role in confirming fungal infections by demonstrating these organisms in tissue. The morphology of fungi in tissue can often be specific to their genus or order, aiding pathological diagnosis. However, the presence of atypical fungal forms can complicate identification. For example, Aspergillus hyphae, which are typically thin and exhibit dichotomous acute-angle branching, may display atypical features such as varicose changes, twisting, and hyperseptation. These morphological variations can hinder the accurate identification of Aspergillus in tissue. Similarly, characteristics of hyphae from hyaline fungi, including Fusarium, Scedosporium, Trichosporon, and Mucorales, must be carefully interpreted, considering the inherent limitations of morphological diagnosis. Tinctorial characteristics are often useful for identifying fungi in tissue. For instance, brown coloration in hematoxylin and eosin-stained tissue and Fontana-Masson stain positivity can help differentiate dematiaceous fungi from hyaline fungi. However, these staining characteristics have limitations and potential pitfalls. Pale, brown-colored dematiaceous fungi may occasionally appear, and hyaline fungi may sometimes exhibit Fontana-Masson stain positivity, leading to diagnostic challenges. Understanding these morphological and tinctorial variations is essential for accurate histopathological identification of fungal infections in tissue.</p>","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"66 3","pages":"139-146"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tomotaka Sato, Hisashi Kobayashi, Aya Okaniwa, Miyuki Okada
{"title":"Diagnosis of Onychomycosis and Real-World Data of Oral Fosravconazole in Japan.","authors":"Tomotaka Sato, Hisashi Kobayashi, Aya Okaniwa, Miyuki Okada","doi":"10.3314/mmj.25.005","DOIUrl":"https://doi.org/10.3314/mmj.25.005","url":null,"abstract":"<p><p>In Japan, two topical drugs and three oral antifungal drugs are prescribed for onychomycosis. Fosravuconazole L-lysine ethanolate (F-RVCZ) is an azole antifungal drug that has been prescribed in Japan since 2018 for the oral treatment of onychomycosis. Herein, we review the real-world evidence of F-RVCZ treatment for cutaneous fungal infection in Japan. The number of prescriptions for F-RVCZ has been increasing. It is more effective than topical drugs and has a favorable safety profile. On the other hand, side effects include elevation of liver enzymes, such as γ-GTP, and renal dysfunction in aged patients. Real-world case reports suggest that F-RVCZ is effective in treating other forms of tinea such as tinea capitis and tinea corporis. The diagnosis of onychomycosis is typically based on KOH direct examination; however, the dermatophyte test strip is used in specific situations where microscopy is difficult to perform such as in house-call medical practice.</p>","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"66 3","pages":"147-149"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"CRISPR-Cas9 RNP-Mediated Deletion of ERG25 in Non-albicans Candida Species, Including Candida auris.","authors":"Michiyo Okamoto, Kaname Sasamoto, Azusa Takahashi-Nakaguchi, Fujiang Zhao, Masashi Yamaguchi, Hiroji Chibana","doi":"10.3314/mmj.24-00023","DOIUrl":"https://doi.org/10.3314/mmj.24-00023","url":null,"abstract":"<p><p>The incidence of infections caused by non-albicans Candida (NAC) species, including Candida glabrata and Candida tropicalis, has recently increased. Furthermore, Candida auris, a multidrug-resistant yeast, poses a serious threat to global health. The development of novel antifungal agents with alternative mechanisms of action is necessary to combat these fungi. However, genetic analyses of the virulence factors in these NAC species are insufficient for this purpose. Recent advancements in the clustered regularly interspaced short palindromic repeat (CRISPR)-Cas9 system have facilitated enhanced the genetic analysis of NAC species. The RNP-based system, in which the Cas9-gRNA complex is assembled in vitro and introduced into cells, offers a simplified approach to genetic modification, eliminating the need for species-specific plasmids. Previous our research identified the ERG25 gene, which encodes C-4 sterol methyl oxidase, as a promising antifungal target in C. glabrata. This study demonstrated deletion of the ERG25 homolog in C. glabrata and C. auris using an RNP-based CRISPR-Cas9 system. The deletion of ERG25 in C. auris and C. glabrata indicated that Erg25 is crucial for the survival of these pathogenic yeasts within the host. Furthermore, we have successfully deleted the ERG25 alleles in C. tropicalis and Candida parapsilosis, demonstrating the effectiveness of using both the CRISPR-Cas9 and Cre-loxP systems in these species for the first time.</p>","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"66 2","pages":"35-43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Importance of Collaboration Between Microbiology Laboratories, Pathology Departments, Dermatologists, and Clinical Mycologists in the Diagnosis of Fungal Infectious Diseases Through the Accurate Detection of Fungi.","authors":"Shigeki Misawa","doi":"10.3314/mmj.25.002","DOIUrl":"10.3314/mmj.25.002","url":null,"abstract":"<p><p>Fungal detection by microbiology testing is essential for diagnosing fungal infections. In routine clinical microbiology, limited specimens are automatically covered for fungi; hence, detection of fungi from many other clinical specimens depends on requests from clinicians. Microbiology laboratories should collaborate with clinicians to build a system to ensure that tests can be requested. Microbiology laboratories determine culture conditions based on the epidemiology of fungal infections by specimen types. If a fungus is detected on microscopic examination, it is highly significant as a causative, and if detected on pathological examination, it can be additionally differentiated from other fungal species. Microbiology laboratories, clinicians, and pathology departments must share information and improve fungal detection. When a small number of fungi are detected in culture, clinical backgrounds are essential for interpretation, and collaboration with a clinician and assistance from a dermatologist or clinical mycologist can make the diagnosis more certain.Collaboration with microbiology laboratories, pathology departments, dermatologists, and clinical mycologists can help clinicians and lead to diagnostic support for fungal infections.</p>","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"66 2","pages":"75-85"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case of Invasive Rhinosinusitis Caused by Penicillium brasilianum.","authors":"Yuki Hirao, Hiroshi Morioka, Shinya Ozaki, Makoto Kawachi, Sayaka Ban, Takashi Yaguchi, Akira Watanabe","doi":"10.3314/mmj.24-00015","DOIUrl":"https://doi.org/10.3314/mmj.24-00015","url":null,"abstract":"<p><p>Penicillium brasilianum is an environmental filamentous fungus with useful applications in biotechnology. However, human infections caused by P. brasilianum are rare and not well understood. We present the case of a woman in her sixties with poorly controlled diabetes mellitus who was diagnosed with invasive fungal rhinosinusitis (IFRS) and orbital apex syndrome. She underwent endoscopic sinus surgery and received treatment with liposomal amphotericin B. Notably, β-tubulin gene sequencing identified the filamentous fungus as P. brasilianum, and long-term itraconazole administration suppressed IFRS flares. Our findings underscore the need for increased awareness and understanding of rare fungal pathogens in clinical practice.</p>","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"65 4","pages":"111-115"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case of Tinea Barbae due to Trichophyton mentagrophytes Presenting as a Tumor.","authors":"Hiroshi Tanabe","doi":"10.3314/mmj.24-00018","DOIUrl":"10.3314/mmj.24-00018","url":null,"abstract":"<p><p>I report a case of tinea barbae presenting as a tumor in the philtrum of a man in his thirties with comorbid alcoholic liver disease. The patient also had tinea on the auricles, neck, and feet, with direct microscopy confirming the presence of dermatophytes at all sites. A history of multiple pet ownership was noted. The causative organism in the philtrum was identified as the zoophilic fungus Trichophyton mentagrophytes, while the tinea on the feet was caused by the anthropophilic fungus Trichophyton interdigitale ITS genotype II. Despite abnormal liver enzymes, the patient was cured after a three-month course of oral terbinafine following cessation of alcohol intake. This case, encountered by the author approximately 20 years ago, was initially identified as Arthroderma vanbreuseghemii using PCR-RFLP analysis of the ITS region of rRNA genes. Recent sequencing analysis of preserved strains reidentified the organism as T. mentagrophytes. The alignment of this strain showed a query cover of 100% and a percent identity (Per.ident) of 99.84%, matching with T. mentagrophytes ITS genotype VII. As a dermatologist, it is crucial to continuously monitor the evolving taxonomy of fungi and its clinical implications.</p>","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"65 4","pages":"93-98"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dermoscopic Examination of Tinea Nigra on the Plantar Foot Unveils a Parallel Ridge Pattern Mimicking Acral-Lentiginous Melanoma.","authors":"Mako Saikawa, Utako Kimura, Yuka Ikari, Ayaka Miyata, Takahide Kaneko, Masataro Hiruma, Takashi Yaguchi, Masaru Tanaka, Kenji Takamori, Yasushi Suga","doi":"10.3314/mmj.24-00010","DOIUrl":"https://doi.org/10.3314/mmj.24-00010","url":null,"abstract":"<p><p>A man in his thirties patient visited his previous physician with the chief complaint of a pigmented macule on the sole of his left foot that had steadily grown over the past two years. A dermoscopic examination of the lesion showed a parallel ridge pattern (PRP); therefore, acral-lentiginous melanoma (ALM) was suspected, and the patient was referred to our hospital for a more detailed examination. On closer inspection, PRP had a well-defined and irregular border with no variation in color, which is atypical for ALM which is characterized by asymmetrical structure and variation in colors. Therefore, a skin biopsy was performed for a definite diagnosis, and the histopathological findings showed mycelia in the horny layers. Fungal culture revealed Hortaea werneckii, and the patient was diagnosed with tinea nigra (TN). Although TN is a rare fungal infection in Japan, we emphasize that this fungal infection should be noted as a mimic of ALM and should be considered when PRP is detected on the palms and soles by dermoscopic examination.</p>","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"65 4","pages":"103-106"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Overview of Fungi Classified as Risk Group 3 by the Japanese Society for Medical Mycology.","authors":"Masato Tashiro, Takahiro Takazono, Koichi Izumikawa","doi":"10.3314/mmj.24.008","DOIUrl":"10.3314/mmj.24.008","url":null,"abstract":"<p><p>Fungi are categorized into Risk or Hazard Groups, depending on their potential to harm humans, with groupings ranging from 1 (least risky) to 4 (most risky). Similarly, Biosafety or Containment Levels ranging from 1 to 4 denote the level of control over microorganisms in laboratories. This review focuses on fungi categorized as Risk Group 3 by the Biosafety Committee of the Japanese Society for Medical Mycology. One such fungus is Blastomyces dermatitidis, which is primarily found in North America and causes blastomycosis, a condition that can result in a pulmonary or disseminated disease. It is classified as Risk Group 3, as substantiated by 11 laboratory-acquired infections and two fatalities. Cladophialophora bantiana, commonly found in Asia, causes brain abscesses and is also classified as Risk Group 3 due to a high mortality rate of 65.2%. Coccidioides immitis/posadasii, found in the Americas, can cause severe respiratory conditions with the potential for dissemination. Their Risk Group 3 classification is substantiated by a history of laboratory-acquired infections. Histoplasma capsulatum, which is found globally, causes a range of infections, from asymptomatic to fatal. Its classification as Risk Group 3 is substantiated by 81 laboratory-acquired infections and one fatality. Rhinocladiella mackenziei, which primarily affects the nervous system, has a mortality rate of 92.5% and is also classified as Risk Group 3. These fungi necessitate strict containment measures in laboratories owing to their high mortality rates or reported cases of laboratory-acquired infections and fatalities, emphasizing the critical need for heightened awareness and stringent safety protocols.</p>","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"65 4","pages":"99-102"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kazuki Amemiya, Sota Sadamoto, Ken Miyazawa, Minoru Shinozaki, Sayaka Ban, Yoshitsugu Miyazaki, Somay Yamagata Murayama, Kazutoshi Shibuya, Naobumi Tochigi
{"title":"Optimization of Silver Staining in Artificial Cytology Samples of Filamentous Fungi.","authors":"Kazuki Amemiya, Sota Sadamoto, Ken Miyazawa, Minoru Shinozaki, Sayaka Ban, Yoshitsugu Miyazaki, Somay Yamagata Murayama, Kazutoshi Shibuya, Naobumi Tochigi","doi":"10.3314/mmj.24-00009","DOIUrl":"https://doi.org/10.3314/mmj.24-00009","url":null,"abstract":"<p><p>The diagnosis of respiratory fungal infections is often aided by cytopathological evidence of fungi in sputum or bronchoalveolar lavage fluid. Grocott's methenamine silver (GMS) stain, a special stain frequently used to detect fungi in cytological specimens, can be challenging to apply stably. There is a need for improved documentation of staining procedures for fungal detection in cytological specimens. In our study, we developed an artificial cytology specimen for fungal detection by combining cultured fungi with artificial sputum. We compared the conventional GMS protocol with the periodic acid-ammoniacal silver (PAAS) protocol, which our institute uses for cytological samples. Our findings revealed that the PAAS protocol, while showing comparable staining properties to the GMS protocol, resulted in fewer non-specific silver granules in the background. Therefore, we conclude that the PAAS protocol offers a valuable alternative for identifying fungi in cytological specimens.</p>","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"65 4","pages":"85-91"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Mother and Daughter with Tinea Corporis Caused by Microsporum canis Apparently Transmitted from a Domestic Cat.","authors":"Kinako Ikeda, Takasuke Ogawa, Yumi Ogawa, Masataro Hiruma, Rui Kano, Shigaku Ikeda","doi":"10.3314/mmj.24-00012","DOIUrl":"10.3314/mmj.24-00012","url":null,"abstract":"<p><p>The patient was a girl (case 1) and her mother (case 2). The family had purchased a domestic cat five months previously. Three months later, both patients developed eruptions. Mycological examinations were positive in both cases, and the cat tested positive on the hairbrush test. The macroconidia were thick only in the cat strain, and drug susceptibility testing showed mildly low levels of terbinafine and itraconazole. However, a molecular biological analysis of these three strains showed 100% identity with reference strains of Microsporum canis. Since there have been recent reports of drug-resistant dermatophytosis, drug-susceptibility testing is considered necessary.</p>","PeriodicalId":520314,"journal":{"name":"Medical mycology journal","volume":"65 4","pages":"107-110"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}