Native Joint Infections by Aspergillus Species

Background: Septic arthritis due to Aspergillus spp. represents a rare, but severe disease. Nevertheless, clear guidelines regarding most effective medical treatment have not yet been established. The present study is a literature review of all reported cases of fungal septic arthritis due to Aspergillus spp, in order to clarify epidemiology, as well as the medical and operative management and their outcome. Methods: A meticulous review of all published septic arthritis infections due to Aspergillus has been conducted. Information regarding demographics, causative fungus, antifungal treatment (AFT), surgical intervention, as well as the infection’s outcome were recorded and evaluated. Results: A total of 30 Aspergillus spp. strains from 29 hosts have been studied. The patients’ mean age was 45.8 years. The most commonly affected joint was the knee (45.7%), while the predominant symptom was joint pain (62%). Most patients were immunocompromised (72.4%). Diagnosis was established through cultures and/or histopathology. Aspergillus fumigatus was the most common responsible fungi (63.3%), followed by A. flavus (16.6%) and A. terreus (10%). Regarding AFT, the preferred agent proved to be Amphotericin B (14 cases; 48.3%), followed by voriconazole (11; 37.9%), while the mean AFT duration was 5.6 months. In most cases surgical treatment was also performed (in 4 cases no surgery was reported). Treatment was effective in 20 cases (69%). Conclusions: Septic arthritis caused by Aspergillus spp. represents a severe clinical entity. It seems that, with the available data, prolonged AFT along with surgical intervention is the preferred management of this infection, while identification of the responsible fungus is of utmost importance.

A Reference Laboratory Surveillance on Fungal Isolates from Patients with Haematological Malignancy in Japan

Invasive fungal disease (IFD) in patients with haematological disorders is a fatal disease, making rapid identification and treatment crucial. However, the identification of the causative fungus is often difficult, sometimes even impossible. There have been few reports concerning the causative species of IFD. This study aimed to investigate the epidemiology and causative organism of IFD in patients with haematological diseases in Japan. We analyzed the IFD cases among the patients with haematological malignancies identified at the Medical Mycological Research Center, Chiba University, between 2013 and 2019. The most common underlying disease was acute myeloid leukaemia (34.3%). Forty-six point one percent of IFD patients received haematopoietic stem cell transplantation (HSCT). The major pathogens were Aspergillus, Candida, and Fusarium. Aspergillus fumigatus was the most common Aspergillus species, and Candida fermentati and Fusarium petroliphilum were the most common Candida and Fusarium species, respectively, in this analysis. Furthermore, various cryptic species and non-albicans Candida were identified. The drug susceptibility of such relatively rare strains suggests that analysis of the causative fungi should provide valuable information for therapeutic options. Therefore, our study indicated that it is clinically significant to identify the organism in as much detail as possible.

Identification of the gut commensal Candida parapsilosis as a causative fungus for the development of high fat-diet induced obesity in mice

Gut fungi is known to play many important roles in human health regulations. Herein, we investigated the anti-obesity efficacy of the antifungal antibiotics (amphotericin B, fluconazole and 5-fluorocytosine) in the high fat diet-fed (HFD) mice. Supplementation of amphotericin B or fluconazole in water effectively inhibited obesity and its related disorders, whereas 5-fluorocytosine exhibited little effects. The gut fungus Candida parapsilosis was identified as a key commensal fungus related to the diet-induced obesity by the culture-dependent method and the inoculation assay with C. parapsilosis in the fungi-free mice. In addition, the increase of free fatty acids in the gut due to the production of fungal lipases from C. parapsilosis was confirmed as one mechanism by which C. parapsilosis promotes obesity. The current study demonstrates the gut C. parapsilosis as a causal fungus for the development of diet-induced obesity in mice and highlights the therapeutic strategy targeting the gut fungi.

Sporotrichosis: A brief review

Sporotrichosis is a chronic mycotic infection caused by dimorphic fungus Sporothrix schenckii, a common saprophyte of soil and plant detritus. According to recent phylogenetic studies, it is a complex of at least six cryptic species with distinct biochemical properties, geographical distribution, virulence, disease patterns, and therapeutic response. S. globosa is the commonest isolated strain in India and evidently responsible for most cases of treatment failure. The disease is endemic in tropical/subtropical regions with occasional large breakouts. In India most cases have been reported along the sub-Himalayan regions. The characteristic cutaneous and subcutaneous infection follows traumatic inoculation of the pathogen. Zoonotic transmission attributed to insect/bird bites, fish handling, and bites of animals is perhaps because of wound contamination from infected dressings or indigenous/herbal poultices and so is human-to-human spread. Progressively enlarging papulo-nodule(s) at the inoculation site develop(s) after a variable incubation period which will evolve into fixed cutaneous sporotrichosis or lymphocutaneous sporotrichosis. Primary pulmonary sporotrichosis following inhalation of conidia and osteoarticular sporotrichosis due to direct inoculation are rare forms. Persons with immunosuppression (HIV, immunosuppressive and anticancer therapy) may develop disseminated cutaneous sporotrichosis or systemic sporotrichosis particularly involving central nervous system. Clinical suspicion is the key for early diagnosis and histologic features remain variable. The demonstration of causative fungus in laboratory culture is confirmatory. Oral itraconazole is the currently recommended treatment for all forms of sporotrichosis but saturated solution of potassium iodide is still used as first-line treatment for uncomplicated cutaneous sporotrichosis in resource poor settings. Terbinafine has been found effective in the treatment of cutaneous sporotrichosis in few studies. Amphotericin B is used initially for the treatment of severe or systemic disease, during pregnancy and in immunosuppressed patients until recovery, and follow-on therapy is with itraconazole until complete (mycological) cure. Posaconazole and ravuconazole remain understudied while echinocandins and voriconazole are not effective.

In Vivo Efficacy of Lacticaseibacillus rhamnosus L8020 in a Mouse Model of Oral Candidiasis

Oral candidiasis presents with multiple clinical manifestations. Among known pathogenic Candida species, Candida albicans is the most virulent and acts as the main causative fungus of oral candidiasis. Novel treatment modalities are needed because of emergent drug resistance and frequent candidiasis recurrence. Here, we evaluated the ability of Lacticaseibacillus rhamnosus L8020, isolated from healthy and caries-free volunteers, to prevent against the onset of oral candidiasis in a mouse model. Mice were infected with C. albicans, in the presence or absence of L. rhamnosus L8020. The mice were treated with antibiotics and corticosteroid to disrupt the oral microbiota and induce immunosuppression. We demonstrated that oral consumption of L. rhamnosus L8020 by C. albicans-infected mice abolished the pseudomembranous region of the mouse tongue; it also suppressed changes in the expression levels of pattern recognition receptor and chemokine genes. Our results suggest that L. rhamnosus L8020 has protective or therapeutic potential against oral candidiasis, which supports the potential use of this probiotic strain for oral health management.

A STUDY ON CHROMOBLASTOMYCOSIS IN A TERTIARY CARE HOSPITAL (DMCH), LAHERIASARAI, BIHAR

Background: Chromoblastomycosis, a chronic subcutaneous mycosis, is caused by several dematiaceous Fungi, the most common being Fonsecaea pedrosoi. A majority of cases from India have been reported from the sub-Himalayan belt and South India. Aim: The aim was to study chromoblastomycosis in around Darbhanga reason of Bihar including demographic and clinicomycological prole. Materials and Methods: This report is a retrospective hospital record-based analysis of all cases of chromoblastomycosis who presented to the dermatology outpatient department of our tertiary care hospital during the past 3 years. Results : A total of 11 cases of chromoblastomycosis were diagnosed during the above period. The disease was seen predominantly in middle-aged male. The lower extremity (72.7%) was more commonly affected. Verrucous and nodular lesions are the common clinical presentation. Sclerotic bodies are demonstrated in potassium hydroxide mount and histopathological section in 81.8% and 90.9% cases, respectively. The causative fungus was isolated in 90.9% and cass with F. pedrosoi, as the most common species

Clinico-mycological profile of onychomycosis in Assam, India

Background: Onychomycosis (OM) is a common nail disorder caused by dermatophytes, non-dermatophyte moulds and yeasts. The increased prevalence of OM along with the wide range of associated fungi necessitates the accurate labora­tory isolation and identification of the causative fungus for optimal management strategies. The aim of the study was to evaluate clinical, epidemiological and mycological characteristics of OM in a tertiary care hospital in Assam.Methods: It was a prospective hospital-based study. Hundred consecutive patients clinically diagnosed as OM were subjected to detailed history, clinical examination and investigations. Nail clipping and subungual debris of OM patients were subjected to KOH preparation and culture. Isolates were identified by colony characters, pigment production, microscopic morphology and biochemical tests.Results: The maximum number of OM cases belonged to the age group 21-30 years with a male preponderance (M:F=1.7:1). The commonest clinical type of OM was distal lateral subungual onychomycosis (DLSO) (51%). Toe nails OM was the most common presentation (54%). Trauma (35%) was the most common predisposing factor. Farmers (agro industry labourers) (23%) were found to be the most commonly affected group. Non-dermatophyte moulds (NDM) accounted for 38(47.5%) of OM cases followed by yeast 27(33.8%) and dermatophytes 15(18.8%).Conclusions: Early diagnosis and treatment is important to prevent distortion of the nails which can prevent loss of working efficiency of the commonly affected population of this region.

Relato de ocorrência da ferrugem da teca, causada por Olivea neotectonae no Estado de Goiás

<p>A Teca (<em>Tectona grandis</em>) é uma planta originaria da Ásia e vêm sendo cultivada principalmente nas regiões Norte e Centro Oeste do Brasil. Porém algumas doenças podem provocar danos à produtividade e crescimento desta espécie, dentre estas fitopatologias está à ferrugem. Este trabalho objetivou-se a relatar a ocorrência do fungo <em>Olivea neotectonae</em>, causador da ferrugem na teca, pela primeira vez no Estado de Goiás. Em maio de 2013, foram observadas folhas da teca com sintomas de necroses que posteriormente provocavam desfolha precoce das plantas. Para avaliação inicial, folhas de teca foram coletadas em plantas localizadas na área do Instituto Federal Goiano Câmpus Ceres-GO. Em seguida, estas foram levadas ao laboratório de Microbiologia do Departamento de Ciências Agrárias. Na observação em microscópio óptico, foram visualizadas e medidas as estruturas fúngicas. Diante dos resultados obtidos no presente trabalho, pode-se concluir que o fungo causador de necroses em plantas observadas no estado de Goiás, trata-se do patógeno <em>Olivea neotectonae, </em>agente causal da ferrugem da Teca.</p><p align="center"><strong>Report of teak rust, caused by <em>Olivea neotectonae </em>in the Goiás<em> </em>State<em></em></strong></p><pre><strong>Abstract: </strong>Teak (<em>Tectona grandis </em>L<em>.</em>) is an Asian plant and it has been cultivated mainly in the North and Midwest of Brazil. However, some diseases can decrease its productivity and growth, such as rust (<em>Olivea neotectonae</em>). This study aimed at reporting <em>O. neotectonae</em> in teak for the first time in the Goiás State. In May 2013, teak leaves were found with necrosis and subsequently fell untimely causing defoliation in plants. As initial analysis, teak leaves were collected from plants located in the area of the Federal Institute Goiano Campus Ceres-GO. Then leaves were taken to the microbiology laboratory of the Department of Agricultural Sciences and analyzed as well as measured under optical microscope for fungal structures. Based on the results of this study, we conclude that the causative fungus necrosis found in plants in the Goiás State is <em>Olivea neotectonae</em>, the causal agent of rust teak.</pre>