Endemic dimorphic fungi

2017 ◽  
Author(s):  
Angela Restrepo ◽  
Angel A. Gónzalez ◽  
Beatriz L. Gómez
Keyword(s):  
Histoplasma Capsulatum ◽  
Paracoccidioides Brasiliensis ◽  
Fungal Spores ◽  
Coccidioides Immitis ◽  
Dimorphic Fungi ◽  
Clinical Presentations ◽  
Causative Agents ◽  
Risk Patients ◽  
Level 3 ◽  
Biosafety Level

Endemic dimorphic infections are acquired by inhalation of fungal spores which undergo a thermal transition to a yeast-like phase in the host. The causative organisms are geographically restricted and are isolated from the environment; likewise, the infections are associated with people living in, or visiting, these endemic regions. The clinical presentations range from asymptomatic to chronic, and disseminated, depending on the host immune status and other risk factors. The infections and their causative agents are: histoplasmosis (Histoplasma capsulatum), paracoccidioidomycosis (Paracoccidioides brasiliensis/lutzii), blastomycosis (Blastomyces dermatitidis/gilchristii), coccidioidomycosis (Coccidioides immitis/posadasii), talaromycosis (previously penicilliosis; Talaromyces [Penicillium] marneffei), and emmonsiosis (Emmonsia species). Diagnosis relies on microscopy and culture, histology, and immunological detection. Owing to their infectious nature, all of these organisms must be handled using biosafety level-3 containment. Treatment is based around azole administration, usually itraconazole, with amphotericin B for the more severe forms or for the most at risk patients.

scholarly journals In Vitro Activities of Voriconazole, Itraconazole, and Amphotericin B against Blastomyces dermatitidis,Coccidioides immitis, and Histoplasma capsulatum

2000 ◽  
Vol 44 (6) ◽  
pp. 1734-1736 ◽  
Author(s):  
Ren-Kai Li ◽  
Meral A. Ciblak ◽  
Nicole Nordoff ◽  
Lester Pasarell ◽  
David W. Warnock ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Histoplasma Capsulatum ◽  
Clinical Laboratory ◽  
Lethal Effect ◽  
Blastomyces Dermatitidis ◽  
National Committee ◽  
Human Pathogens ◽  
Coccidioides Immitis ◽  
Dimorphic Fungi

ABSTRACT The in vitro activity of voriconazole was compared to those of itraconazole and amphotericin B against the mold forms of 304 isolates of three dimorphic fungi, Blastomyces dermatitidis,Coccidioides immitis, and Histoplasma capsulatum. MICs were determined by a broth microdilution adaptation of the National Committee for Clinical Laboratory Standards M27-A procedure. RPMI 1640 medium was used for tests with voriconazole and itraconazole, whereas Antibiotic Medium 3 with 2% glucose was used for amphotericin B. Minimum fungicidal concentrations (MFCs) were also determined. Amphotericin B was active against all three dimorphic fungi, with MICs at which 90% of the isolates tested are inhibited (MIC90s) of 0.5 to 1 μg/ml. Itraconazole had MIC90s of 0.06 μg/ml for H. capsulatum, 0.125 μg/ml for B. dermatitidis, and 1 μg/ml for C. immitis. The MIC90s of voriconazole were 0.25 μg/ml for all three fungi. Amphotericin B was fungicidal for B. dermatitidis and H. capsulatum with MFCs at which 90% of strains tested are killed (MFC90s) of 0.5 and 2 μg/ml, respectively. It was less active against C. immitis, with MFCs ranging from 0.5 to >16 μg/ml. Voriconazole and itraconazole were lethal for most isolates of B. dermatitidis, with MFC50s and MFC90s of 0.125 and 4 μg/ml, respectively. Both azoles were fungicidal for some isolates of H. capsulatum, with MFC50s of 2 and 8 μg/ml for itraconazole and voriconazole, respectively; neither had a lethal effect upon C. immitis. Our results suggest that voriconazole possesses promising activity against these important human pathogens.

scholarly journals The Broad Clinical Spectrum of Disseminated Histoplasmosis in HIV-Infected Patients: A 30 Years’ Experience in French Guiana

2019 ◽  
Vol 5 (4) ◽  
pp. 115 ◽  
Author(s):  
Pierre Couppié ◽  
Katarina Herceg ◽  
Morgane Bourne-Watrin ◽  
Vincent Thomas ◽  
Denis Blanchet ◽  
...  
Keyword(s):  
French Guiana ◽  
Histoplasma Capsulatum ◽  
Opportunistic Infections ◽  
Clinical Findings ◽  
Diagnostic Methods ◽  
Medical Mycology ◽  
Time To Initiation ◽  
Level 3 ◽  
Endemic Areas ◽  
Biosafety Level

Histoplasmosis is a common but neglected AIDS-defining condition in endemic areas for Histoplasma capsulatum. At the advanced stage of HIV infection, the broad spectrum of clinical features may mimic other frequent opportunistic infections such as tuberculosis and makes it difficult for clinicians to diagnose histoplasmosis in a timely manner. Diagnosis of histoplasmosis is difficult and relies on a high index of clinical suspicion along with access to medical mycology facilities with the capacity to implement conventional diagnostic methods (direct examination and culture) in a biosafety level 3 laboratory as well as indirect diagnostic methods (molecular biology, antibody, and antigen detection tools in tissue and body fluids). Time to initiation of effective antifungals has an impact on the patient’s prognosis. The initiation of empirical antifungal treatment should be considered in endemic areas for Histoplasma capsulatum and HIV. Here, we report on 30 years of experience in managing HIV-associated histoplasmosis based on a synthesis of clinical findings in French Guiana with considerations regarding the difficulties in determining its differential diagnosis with other opportunistic infections.

scholarly journals Low Utility of Pediatric Isolator Blood Culture System for Detection of Fungemia in Children: a 10-Year Review

2016 ◽  
Vol 54 (9) ◽  
pp. 2284-2287 ◽  
Author(s):  
Aaron Campigotto ◽  
Susan E. Richardson ◽  
Michael Sebert ◽  
Erin McElvania TeKippe ◽  
Aparna Chakravarty ◽  
...  
Keyword(s):  
Blood Culture ◽  
Histoplasma Capsulatum ◽  
Medical Center ◽  
Clinical Information ◽  
Automated System ◽  
Coccidioides Immitis ◽  
Dimorphic Fungi ◽  
Fungal Isolation ◽  
Content Type ◽  
Clinically Significant

The use of the Wampole Isolator 1.5-ml pediatric blood culture tube for the detection of fungemia in children was assessed by a 10-year retrospective review at two pediatric hospitals, The Hospital for Sick Children in Toronto, Canada, and the Children's Medical Center of Dallas, Texas. Over this period, a total of 9,442 pediatric Isolator specimens were processed, with yeast or yeast-like organisms recovered in 297 (3.1%) of the specimens (151 [1.6%] unique clinical episodes) and filamentous or dimorphic fungi recovered in 31 (0.3%) of the specimens (25 unique clinical episodes). Only 18 of the 151 clinical episodes of fungemia attributable to yeast were not detected by automated blood culture systems. The majority of isolated yeast wereCandidaspp., which were usually detected by automated systems, whereas the most common non-Candidayeast wasMalassezia furfur, which the automated system failed to detect. Filamentous or dimorphic fungi were detected in 25 episodes, of which only 9 (36%) episodes were deemed clinically significant after chart review, indicating that in the majority of cases (16/25, 64%) fungal isolation represented contamination. In five of the nine clinically significant episodes, the isolated fungus (Histoplasma capsulatum,Coccidioides immitis/posadasii,Fusarium oxysporum,Aspergillusspp., andBipolarisspp.) was also identified in other clinical specimens. Over the 10-year study period, the use of the pediatric Isolator system, at the discretion of the treating physician, only rarely provided useful clinical information for the diagnosis of fungemia in children, with the exception ofM. furfurand possibly endemic mycoses.

scholarly journals Virulence Factors IN Fungi OF Systemic Mycoses

1998 ◽  
Vol 40 (3) ◽  
pp. 125-136 ◽  
Author(s):  
Cilmery Suemi KUROKAWA ◽  
Maria Fátima SUGIZAKI ◽  
Maria Terezinha Serrão PERAÇOLI
Keyword(s):  
Virulence Factors ◽  
Defense Mechanisms ◽  
Histoplasma Capsulatum ◽  
Paracoccidioides Brasiliensis ◽  
Pathogenic Fungi ◽  
Infection Process ◽  
Coccidioides Immitis ◽  
Adverse Conditions ◽  
Complex Processes ◽  
Hostile Environments

Pathogenic fungi that cause systemic mycoses retain several factors which allow their growth in adverse conditions provided by the host, leading to the establishment of the parasitic relationship and contributing to disease development. These factors are known as virulence factors which favor the infection process and the pathogenesis of the mycoses. The present study evaluates the virulence factors of pathogenic fungi such as Blastomyces dermatitidis, Coccidioides immitis, Cryptococcus neoformans, Histoplasma capsulatum and Paracoccidioides brasiliensis in terms of thermotolerance, dimorphism, capsule or cell wall components as well as enzyme production. Virulence factors favor fungal adhesion, colonization, dissemination and the ability to survive in hostile environments and elude the immune response mechanisms of the host. Both the virulence factors presented by different fungi and the defense mechanisms provided by the host require action and interaction of complex processes whose knowledge allows a better understanding of the pathogenesis of systemic mycoses.

Paracoccidioides spp. and Histoplasma capsulatum: Current and New Perspectives for Diagnosis and Treatment

2018 ◽  
Vol 18 (15) ◽  
pp. 1333-1348 ◽  
Author(s):  
C.P. Taborda ◽  
R. Buccheri ◽  
G. Benard ◽  
A.N. Duarte-Neto ◽  
J.D. Nosanchuk ◽  
...  
Keyword(s):  
Histoplasma Capsulatum ◽  
Paracoccidioides Brasiliensis ◽  
Modern Medicine ◽  
Clinical Aspects ◽  
Mammalian Host ◽  
Human Pathogens ◽  
Coccidioides Immitis ◽  
Natural Habitats ◽  
Fungal Propagules ◽  
Paracoccidioides Spp

The thermally-dimorphic systemic fungal group includes several important human pathogens: Blastomyces dermatitides, Coccidioides immitis and C. posadasii, Histoplasma capsulatum, Paracoccidioides brasiliensis, P. lutzii, and Talaromyces (Penicillium) marneffei. They usually are geographically restricted and have natural habitats in soil or in plants, and when fungal propagules invade mammalian host by inhalation, they initiate an inflammatory reaction that can result in self-resolution of the infection or cause an acute or chronic disease. In the setting of the AIDS pandemic and the developments in modern medicine, such as immunosuppressive therapy in cancer surgery patients and in transplantation and autoimmune diseases, the incidence of endemic mycoses has progressively increased. Another important factor of the increased incidence of systemic mycoses in certain regions is the progressive devastation of tropical and subtropical forests. In this review, we focus on two of the most important systemic mycoses: paracoccidioidomycosis and histoplasmosis, and their major characteristics in epidemiology, clinical aspects and laboratorial diagnosis.

scholarly journals Heat Shock Proteins in Histoplasma and Paracoccidioides

2017 ◽  
Vol 24 (11) ◽  
Author(s):  
Levi G. Cleare ◽  
Daniel Zamith-Miranda ◽  
Joshua D. Nosanchuk
Keyword(s):  
Heat Shock ◽  
Heat Shock Proteins ◽  
Histoplasma Capsulatum ◽  
Passive Immunization ◽  
Dimorphic Fungi ◽  
Content Type ◽  
Diverse Species ◽  
Causative Agents ◽  
Shock Proteins ◽  
Protection Against Infection

ABSTRACT Heat shock proteins (Hsps) are highly conserved biomolecules that are constitutively expressed and generally upregulated in response to various stress conditions (biotic and abiotic). Hsps have diverse functions, categorizations, and classifications. Their adaptive expression in fungi indicates their significance in these diverse species, particularly in dimorphic pathogens. Histoplasma capsulatum and Paracoccidioides species are dimorphic fungi that are the causative agents of histoplasmosis and paracoccidioidomycosis, respectively. This minireview focuses on the pathobiology of Hsps, with particular emphasis on their roles in the morphogenesis and virulence of Histoplasma and Paracoccidioides and the potential roles of active and passive immunization against Hsps in protection against infection with these fungi.

Coccidioidomycosis in Dogs and Cats: A Review

2008 ◽  
Vol 44 (5) ◽  
pp. 226-235 ◽  
Author(s):  
Angela Graupmann-Kuzma ◽  
Beth A. Valentine ◽  
Lisa F. Shubitz ◽  
Sharon M. Dial ◽  
Barbara Watrous ◽  
...  
Keyword(s):  
Variable Degree ◽  
Coccidioides Immitis ◽  
Coccidioides Posadasii ◽  
Cutaneous Lesions ◽  
Dimorphic Fungi ◽  
Tissue Samples ◽  
Causative Agents ◽  
Pulmonary Infiltration ◽  
Disseminated Disease ◽  
Radiographic Changes

The dimorphic fungi Coccidioides immitis and Coccidioides posadasii are the causative agents of coccidioidomycosis. Dogs and cats residing in and visiting endemic areas are at risk of exposure to infectious arthrospores. The primary infection is pulmonary and frequently results in chronic cough. Disseminated disease is common and causes cutaneous, osseous, cardiac, ocular, nervous system, or other organ disease. Radiographic changes include a variable degree of interstitial pulmonary infiltration, hilar lymphadenopathy, and osseous lesions. Serological titers support the diagnosis, but definitive diagnosis relies on identification of Coccidioides in cytological or tissue samples. Coccidioidomycosis should be considered in any dog or cat that has been potentially exposed during the previous 3 years and is presented with chronic illness, respiratory signs, lameness, lymphadenopathy, nonhealing cutaneous lesions, or neurological, ocular, or cardiac abnormalities.

scholarly journals Dimorphic Fungal Coinfection as a Cause of Chronic Diarrhea and Pancolitis

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Eduar A. Bravo ◽  
Arturo J. Zegarra ◽  
Alejandro Piscoya ◽  
José L. Pinto ◽  
Raúl E. de los Rios ◽  
...  
Keyword(s):  
North America ◽  
South America ◽  
Histoplasma Capsulatum ◽  
Chronic Diarrhea ◽  
Paracoccidioides Brasiliensis ◽  
Fungal Diseases ◽  
Systemic Mycosis ◽  
Gastrointestinal Involvement ◽  
Dimorphic Fungi ◽  
Tropical South America

Histoplasma capsulatumandParacoccidioides brasiliensisare dimorphic fungi that cause systemic mycosis mostly in tropical South America and some areas of North America. Gastrointestinal involvement is not uncommon among these fungal diseases, but coinfection has not previously been reported. We report a patient with chronic diarrhea and pancolitis caused by paracoccidioidomycosis and histoplasmosis.

ON THE CELL WALLS OF DIMORPHIC FUNGI CAUSING SYSTEMIC INFECTIONS

1954 ◽  
Vol 1 (1) ◽  
pp. 1-5 ◽  
Author(s):  
F. Blank
Keyword(s):  
Cell Walls ◽  
Histoplasma Capsulatum ◽  
Paracoccidioides Brasiliensis ◽  
Blastomyces Dermatitidis ◽  
Growth Phases ◽  
Electron Microscopic ◽  
Dimorphic Fungi ◽  
Polymeric Substance ◽  
Systemic Infections ◽  
Microscopic Investigations

Cultures of the mycelial and tissue-like growth phases of Blastomyces dermatitidis, Paracoccidioides brasiliensis, Histoplasma capsulatum, and Sporotrichum Schenckii were extracted and oxidized as described by Scholl in 1908. Debye–Scherrer diagrams of the so prepared cell walls show the presence of chitin in both growth phases of each fungus investigated, and give no evidence of the presence of cellulose or another high polymeric substance in the membranes. Nitrogen determinations of the same material corroborate these findings. Electron-microscopic investigations of the isolated chitin of Blastomyces dermatitidis did not reveal any substantial difference in the submicroscopic structures of the framework of the mycelial and yeast-like growth phases.

scholarly journals Effect of cetylpyridinium chloride on pathogenic fungi and Nocardia asteroides in sputum

1976 ◽  
Vol 3 (3) ◽  
pp. 272-276
Author(s):  
B J Phillips ◽  
W Kaplan
Keyword(s):  
Sodium Chloride ◽  
Histoplasma Capsulatum ◽  
Paracoccidioides Brasiliensis ◽  
Fluorescent Antibody ◽  
Cetylpyridinium Chloride ◽  
Sporothrix Schenckii ◽  
Pathogenic Fungi ◽  
Geotrichum Candidum ◽  
Nocardia Asteroides ◽  
Coccidioides Immitis

The effect of cetylpyridinium chloride (CPC) on pathogenic fungi and Nocardia asteroides was studied. Sputa seeded with each of 11 organisms (Aspergillus flavus; Aspergillus fumigatus, Blastomyces dermatitidis, Candida albicans, Coccidioides immitis, Cryptococcus neoformans, Geotrichum candidum, Histoplasma capsulatum; Nocardia asteroides, Paracoccidioides brasiliensis, and Sporothrix schenckii) were treated with CPC and kept for 2, 5 and 9 days. The CPC reagent used (0.5% CPC and 0.5% sodium chloride) is one the Mycobacteriolgoy Branch at the Center for Disease Control added to sputa before shipping them to laboratories for recovery of mycobacteria. None of the organisms tested survived this treatment, and none was recovered on mycological or mycobacteriological media. Seeded sputa containing these organisms were also tested with a second CPC reagent (0.02% CPC and 0.5% sodium chloride) and held for 2, 5 and 9 days. A few colonies of A. flavus, A. fumigatus, and N. asteroides were recovered from these samples. Neither the morphology of the fungi nor their stainability by the fluorescent antibody method was affected by treatment with the reagent containing 0.5% CPC. However, the background material in smears from the 0.5% CPC-treated samples retained the conjugate, and this made weakly fluorescing organisms more difficult to detect. The 0.5% CPC treatment did not alter the morphology of N. asteroides or its ability to be stained with Kinyoun acid-fast stain.

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