MyMedR

Fulltext Detection and Control of Fungal Outbreaks

Caceres DH, Mohd Tap R, Alastruey-Izquierdo A, Hagen F

Mycopathologia, 2020 10;185(5):741-745.

PMID: 33037965 DOI: 10.1007/s11046-020-00494-1

Matched MeSH terms: Mycoses/diagnosis*

Mycotic Keratitis

Ong B, Rose L

Med J Malaya, 1965 Sep;20(1):84-5.

PMID: 4221439

Matched MeSH terms: Mycoses/diagnosis*

Fulltext Non-sporulating Chrysosporium: an opportunistic fungal infection in a neutropenic patient

Gan GG, Kamarulzaman A, Goh KY, Ng KP, Na SL, Soo-Hoo TS

Med J Malaysia, 2002 Mar;57(1):118-22.

PMID: 14569730

We report a case of an invasive infection with non-sporulating Chrysosporium species in a patient who was treated with chemotherapy for relapsed acute lymphoblastic leukemia. This patient presented with a persistent lobar pneumonia, skin lesions, and possible involvement of the central nervous system. The patient responded to treatment with amphotericin B and oral itraconazole.

Matched MeSH terms: Mycoses/diagnosis*

An abdominal mass owing to Penicillium marneffei in an HIV-infected 7-year-old boy: case report

Othman N, Yip CW, Intan HI, Zainuddin Z, Amran F

Ann Trop Paediatr, 2006 Sep;26(3):259-62.

PMID: 16925966

A 7-year-old boy, referred with lymphoma, presented with prolonged fever and intra-abdominal lymphadenopathy demonstrated on computed tomography (CT) of the abdomen. Blood culture isolated Penicillium marneffei. The patient was subsequently proven serologically to be positive for human immunodeficiency virus (HIV). Treatment with amphotericin B followed by itraconazole was successful. A high level of clinical suspicion and awareness is necessary for early diagnosis of penicilliosis, especially in an era of an increasing prevalence of HIV in this region.

Matched MeSH terms: Mycoses/diagnosis*

Non-ulcerative soft tissue mycosis of long duration mimicking soft tissue sarcoma--a case report

Omar E, Murugesan A, Bakar NH, Wan Z

Southeast Asian J. Trop. Med. Public Health, 2005 Nov;36(6):1530-2.

PMID: 16610657

Soft tissue mycosis usually presents with a triad of tumefaction, suppuration and ulceration. We report an unusual case of soft tissue mycosis in a 42-year-old male teacher who presented with painless swelling over the anterolateral aspect of the right shin for 4 years duration.

Matched MeSH terms: Mycoses/diagnosis*

Evaluation of the use of Bactec anaerobic blood cultures in the detection of bacteraemia and fungaemia in children

Riley PA, Parasakthi N

Malays J Pathol, 1996 Jun;18(1):31-4.

PMID: 10879222

In an attempt to reduce costs, the role of Bactec anaerobic blood culture in the detection of bacteraemia and fungaemia in children was evaluated. Results from 3167 sets of aerobic and anaerobic blood cultures from children admitted to the University Hospital, Kuala Lumpur during a one year period, were analysed. Four hundred and eight (12.9%) sets of blood cultures were positive, of which 348 sets (11.0%) from 201 patients were clinically significant. Of the 348 significant positive sets, organisms were isolated on 177 (50.9%) occasions from both aerobic and anaerobic bottles, on 136 (39.1%) occasions from the aerobic bottle only and 35 (10.0%) occasions from the anaerobic bottle only. No strict anaerobes were isolated, but clinically significant isolates recovered from the anaerobic bottle only included Klebsiella pneumoniae, Salmonella species, Enterobacter cloacae, Staphylococcus aureus, coagulase negative staphylococci, Streptococcus pneumoniae and Group B streptococcus. Patients with bacteraemia diagnosed solely by anaerobic culture were distributed evenly across the various paediatric subspecialities. When results from the anaerobic bottles were excluded, the overall isolation rate was reduced from 11% to 9.9%. Potential financial savings resulting from omission of anaerobic cultures must be balanced against the small number of bacteraemic episodes that could be missed. Undiagnosed bacteraemia may result in increased morbidity and mortality with its own attendant financial implications.

Matched MeSH terms: Mycoses/diagnosis*

Fulltext Imported Talaromycosis in Oman in Advanced HIV: A Diagnostic Challenge Outside the Endemic Areas

Mohsin J, Khalili SA, van den Ende AHGG, Khamis F, Petersen E, de Hoog GS, et al.

Mycopathologia, 2017 Aug;182(7-8):739-745.

PMID: 28260132 DOI: 10.1007/s11046-017-0124-x

A 37-year-old male living in Oman was seen by his physician with complaints of cough, body aches with bilateral lower limb weakness and on and off fever. He was diagnosed with HIV infection and culture from blood and bone marrow grew Talaromyces marneffei. He had travelled to Malaysia on several occasions. Treatment with liposomal amphotericin B resulted in complete cure. This case is reported for its rarity and unusual presentation to alert clinicians and microbiologists to consider T. marneffei as an etiology in high risk individuals. Our case is the first recorded diagnosis of T. marneffei in Oman.

Matched MeSH terms: Mycoses/diagnosis*

Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology

Hoenigl M, Salmanton-García J, Walsh TJ, Nucci M, Neoh CF, Jenks JD, et al.

Lancet Infect Dis, 2021 Aug;21(8):e246-e257.

PMID: 33606997 DOI: 10.1016/S1473-3099(20)30784-2

With increasing numbers of patients needing intensive care or who are immunosuppressed, infections caused by moulds other than Aspergillus spp or Mucorales are increasing. Although antifungal prophylaxis has shown effectiveness in preventing many invasive fungal infections, selective pressure has caused an increase of breakthrough infections caused by Fusarium, Lomentospora, and Scedosporium species, as well as by dematiaceous moulds, Rasamsonia, Schizophyllum, Scopulariopsis, Paecilomyces, Penicillium, Talaromyces and Purpureocillium species. Guidance on the complex multidisciplinary management of infections caused by these pathogens has the potential to improve prognosis. Management routes depend on the availability of diagnostic and therapeutic options. The present recommendations are part of the One World-One Guideline initiative to incorporate regional differences in the epidemiology and management of rare mould infections. Experts from 24 countries contributed their knowledge and analysed published evidence on the diagnosis and treatment of rare mould infections. This consensus document intends to provide practical guidance in clinical decision making by engaging physicians and scientists involved in various aspects of clinical management. Moreover, we identify areas of uncertainty and constraints in optimising this management.

Matched MeSH terms: Mycoses/diagnosis*

Disseminated Penicillium marneffei infection: a report of five cases in Singapore

Kurup A, Leo YS, Tan AL, Wong SY

Ann Acad Med Singap, 1999 Jul;28(4):605-9.

PMID: 10561784

Penicillium marneffei has emerged as an important opportunistic pathogen in HIV-infected patients in Southeast Asia. We report the first 5 cases of P. marneffei diagnosed in Singapore. All the patients were HIV-infected and were either Thai nationals or had frequently travelled to Thailand. Fever, weight loss, anaemia and papular skin lesions were common clinical manifestations in our patients, all of whom had the organism isolated from blood. Skin biopsy specimens showed histological evidence of P. marneffei in 2 patients. In 1 patient each, the organism grew in cultures of specimens from bone marrow and respiratory secretions. Amphotericin B therapy followed by itraconazole were used in 3 of our 5 patients and was associated with good clinical response and outcome.

Matched MeSH terms: Mycoses/diagnosis*

Fulltext Penicilliosis in lupus patients presenting with unresolved fever: a report of 2 cases and literature review

Chong YB, Tan LP, Robinson S, Lim SK, Ng KP, Keng TC, et al.

Trop Biomed, 2012 Jun;29(2):270-6.

PMID: 22735849 MyJurnal

Penicilliosis is a rare occurrence among non human immunodeficiency virus (HIV) infected patients. We report here two cases of Penicillium marneffei infection in patients with systemic lupus erythematosus (SLE). Both patients had a recent flare of lupus and were on immunosuppressive drugs when they presented with prolonged fever without an obvious foci of infection, unresponsive to broad-spectrum antibiotics. They were leucopaenic upon admission, with rapid deterioration during the course of the illness. Diagnosis of penicilliosis via fungal isolation from blood culture was delayed resulting in the late initiation of antifungal agents. While both patients ultimately recovered, the delay in diagnosis led to a prolonged hospital stay with increased morbidity. Clinicians should be aware of this uncommon but emerging fungal pathogen in SLE patients and maintain a high index of suspicion in diagnosing this potentially fatal but treatable disease.

Matched MeSH terms: Mycoses/diagnosis*

Fulltext First Two Cases of Fungal Infections Associated with Multi-drug Resistant Yeast, Fereydounia khargensis

Tap RM, Ramli NY, Sabaratnam P, Hashim R, Bakri AR, Bee LB, et al.

Mycopathologia, 2016 Aug;181(7-8):531-7.

PMID: 27010640 DOI: 10.1007/s11046-016-0002-y

The number of new fungal pathogens is increasing due to growing population of immunocompromised patients and advanced identification techniques. Fereydounia khargensis is a yeast and was first described in 2014 from environmental samples. As far as we know, this is the first report of human infections associated with F. khargensis. The yeasts were isolated from blood of a HIV-positive patient and pleural fluid of chronic renal failure patient. Amplification and sequencing of the internal transcribed spacer and the large subunit regions confirmed the identity of the isolates. Both isolates showed multi-drug resistance to antifungal agents tested.

Matched MeSH terms: Mycoses/diagnosis*

Emergence of Aureobasidium pullulans as human fungal pathogen and molecular assay for future medical diagnosis

Chan GF, Puad MS, Chin CF, Rashid NA

Folia Microbiol (Praha), 2011 Sep;56(5):459-67.

PMID: 21909832 DOI: 10.1007/s12223-011-0070-9

Despite the great importance of Aureobasidium pullulans in biotechnology, the fungus had emerged as an opportunistic human pathogen, especially among immunocompromised patients. Clinical detection of this rare human fungal pathogen presently relies on morphology diagnosis which may be misleading. Thus, a sensitive and accurate quantitative molecular assay for A. pullulans remains lacking. In this study, we presented the microscopy observations of A. pullulans that reveals the phenotypic plasticity of the fungus. A. pullulans-specific primers and molecular beacon probes were designed based on the fungal 18S ribosomal RNA (rRNA) gene. Comparison of two probes with varied quencher chemistry, namely BHQ-1 and Tamra, revealed high amplification efficiency of 104% and 108%, respectively. The optimized quantitative real-time PCR (qPCR) assays could detect and quantify up to 1 pg concentration of A. pullulans DNA. Both assays displayed satisfactory performance parameters at fast thermal cycling mode. The molecular assay has great potential as a molecular diagnosis tool for early detection of fungal infection caused by A. pullulans, which merits future study in clinical diagnosis.

Matched MeSH terms: Mycoses/diagnosis*

Demographic characteristics and outcomes of continuous ambulatory peritoneal dialysis related peritonitis in Miri General Hospital, Malaysia

Andy Tang SO, Carolisna YI, Sakura D, Yeo ST, Koh KH

Med J Malaysia, 2019 08;74(4):270-274.

PMID: 31424032

INTRODUCTION: Sarawak has a population that is geographically and characteristically widely varied. In this study we aimed to determine the demographic characteristics of our patient population who undergo continuous ambulatory peritoneal dialysis (CAPD) and to study the incidence, the microbiology and the outcome of CAPD peritonitis.

METHODS: A retrospective record review of all CAPD patients on follow-up at the Miri Hospital, Sarawak, Malaysia from 2014 until 2017 was done.

RESULTS AND DISCUSSION: During the 4-year period, the overall peritonitis rate was 0.184 episodes per patient-year. Gram-positive and gram-negative bacteria each constituted one-third of the peritonitis; fungi (2.6%), Mycobacterium tuberculosis (MTB) (5.3%), polymicrobial (2.6%) and sterile culture (26.3%). The most commonly isolated gram-positive bacteria were coagulase-negative Staphylococcus. Our peritonitis rate is comparable to that of other centres i.e., Japan 0.195 and Indonesia 0.25. In comparison, countries like India (0.41), Korea (0.40) and Singapore (0.59) had relatively higher rate of PD-associated peritonitis. Two tuberculosis peritonitis patients died. The rate of catheter removal was approximately 20%. Gram-negative bacteria and MTB have a higher risk of catheter loss. About one-fifth used rainwater to clean their CAPD exit site. Out of this group, 33% did not boil the rainwater prior to usage.

CONCLUSION: Patient's characteristics and microbial susceptibility vary in different places of practice. The high rates of culture-negative peritonitis and high mortality risks associated with TB peritonitis warrant special attention. In patients with refractory peritonitis, early catheter removal is warranted in order to reduce mortality and minimize damage to peritoneal membrane.

Matched MeSH terms: Mycoses/diagnosis

Cladosporium cladosporioides keratomycosis: a case report

Chew FLM, Subrayan V, Chong PP, Goh MC, Ng KP

Jpn. J. Ophthalmol., 2009 Nov;53(6):657-659.

PMID: 20020251 DOI: 10.1007/s10384-009-0722-3

Matched MeSH terms: Mycoses/diagnosis

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