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European Journal of Dermatology : EJD 2015
Topics: Aged; Antifungal Agents; Chromoblastomycosis; Hand Dermatoses; Humans; Itraconazole; Male; Phialophora
PubMed: 26066414
DOI: 10.1684/ejd.2015.2581 -
Mycoses May 2021Black opportunists Phialophora verrucosa complex species can cause different disease types in competent and in immunocompromised individuals, but are remarkably...
BACKGROUND
Black opportunists Phialophora verrucosa complex species can cause different disease types in competent and in immunocompromised individuals, but are remarkably overrepresented in CARD9-related infections.
OBJECTIVES
To better understand the ecology and potential pathogenicity of opportunistic Phialophora species and reveal eventual genetic parameters associated with the behaviour in vivo and genetic profiles in patients with CARD9 immunodeficiency.
METHODS
Genomes of 26 strains belonging to six species of the Phialophora verrucosa complex were sequenced. Using multilocus analysis, all environmental and clinical strains were identified correctly. We compared the genomes of agents from different disease types among each other including CARD9 immunodeficiency.
RESULTS
We obtained genome sizes of the 26 Phialophora strains ranged between 32 and 37 MB. Some species showed considerable intraspecific genomic variation. P americana showed the highest degree of variability. P verrucosa was variable in CAZy enzymes, whereas P americana varied in PKS-related genes. Phialophora species, particularly P verrucosa, are relatively frequent in patients with CARD9-related immunodeficiency. Different mutations in the CARD9 gene seem to increase susceptibility for infection by different groups of species, that is either Candida, dermatophytes or black fungi. A number of patients with chromoblastomycosis revealed an as yet unknown CARD9 mutation. TNFα impairment was prevalent in patients with CARD9 infections, while CBM patients were invariably IFNγ.
CONCLUSIONS
From genomic investigations, the known virulence factors between clinical and environmental strains did not reveal any significant difference. Phialophora complex has an equal chance to cause infection in humans, either healthy or CARD9-impaired.
Topics: CARD Signaling Adaptor Proteins; Candidiasis; Chromoblastomycosis; Fungal Proteins; Genome, Fungal; Genomics; Humans; Immunocompromised Host; Opportunistic Infections; Phaeohyphomycosis; Phialophora; Phylogeny
PubMed: 33455056
DOI: 10.1111/myc.13244 -
BMC Microbiology May 2011Group 1 introns (ribozymes) are among the most ancient and have the broadest phylogenetic distribution among the known self-splicing ribozymes. Fungi are known to be...
Occurrence and characteristics of group 1 introns found at three different positions within the 28S ribosomal RNA gene of the dematiaceous Phialophora verrucosa: phylogenetic and secondary structural implications.
BACKGROUND
Group 1 introns (ribozymes) are among the most ancient and have the broadest phylogenetic distribution among the known self-splicing ribozymes. Fungi are known to be rich in rDNA group 1 introns. In the present study, five sequences of the 28S ribosomal RNA gene (rDNA) regions of pathogenic dematiaceous Phialophora verrucosa were analyzed using PCR by site-specific primers and were found to have three insertions, termed intron-F, G and H, at three positions of the gene. We investigated the distribution of group 1 introns in this fungus by surveying 34 strains of P. verrucosa and seven strains of Phialophora americana as the allied species.
RESULTS
Intron-F's (inserted at L798 position) were found in 88% of P. verrucosa strains, while intron-G's (inserted at L1921) at 12% and intron-H's (inserted at L2563) at 18%. There was some correlation between intron distribution and geographic location. In addition, we confirmed that the three kinds of introns are group 1 introns from results of BLAST search, alignment analysis and Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR). Prediction of secondary structures and phylogenetic analysis of intron sequences identified introns-F and G as belonging to subgroup IC1. In addition, intron-H was identified as IE.
CONCLUSION
The three intron insertions and their insertion position in the 28S rDNA allowed the characterization of the clinical and environmental isolates of P. verrucosa and P. americana into five genotypes. All subgroups of introns-F and G and intron-H were characterized and observed for the first time in both species.
Topics: DNA Primers; Environmental Microbiology; Genotype; Humans; Introns; Molecular Sequence Data; Mycological Typing Techniques; Mycoses; Nucleic Acid Conformation; Phialophora; Phylogeny; Polymerase Chain Reaction; RNA, Ribosomal, 28S; Sequence Analysis, DNA; Sequence Homology, Nucleic Acid
PubMed: 21548984
DOI: 10.1186/1471-2180-11-94 -
Journal of Medical Case Reports Aug 2018We report a rare case of Phialophora verrucosa fungal keratitis, which required various types of treatment according to the intractable natural history of the disease.
BACKGROUND
We report a rare case of Phialophora verrucosa fungal keratitis, which required various types of treatment according to the intractable natural history of the disease.
CASE PRESENTATION
A 51-year-old Thai man with poorly controlled diabetes received a bamboo branch injury and developed a perforated corneal lesion on his left eye. A pathological study from therapeutic penetrating keratoplasty showed fungal hyphae. This was later identified as Phialophora verrucosa by polymerase chain reaction. This organism was aggressive and recalcitrant because it relapsed with two corneal grafts and was resistant to amphotericin B, natamycin, and itraconazole. However, we found that the efficacy of voriconazole was promising for treating Phialophora verrucosa. We also used corneal cross-linking to establish corneal integrity after the infection was under control.
CONCLUSIONS
Because of the chronic nature of Phialophora verrucosa, a patient's first visit may occur many years after trauma, and sometimes clinical presentation might not appear to indicate fungal infection. Therefore, a high index of suspicion is needed in this situation. Voriconazole showed good results in our case. Instead of using a more invasive keratoplasty, we used corneal cross-linking to strengthen the corneal biomechanics. To the best of our knowledge, this is the first case showing the benefit of corneal cross-linking to improve corneal biomechanics in resolved Phialophora verrucosa keratitis.
Topics: Antifungal Agents; Corneal Diseases; Corneal Injuries; Eye Infections, Fungal; Humans; Keratitis; Male; Middle Aged; Phialophora; Voriconazole
PubMed: 30121073
DOI: 10.1186/s13256-018-1765-1 -
Hand (New York, N.Y.) Jun 2015Deep tissue fungal infections of the hand are exceedingly uncommon. We present a case of fungal tenosynovitis caused by Phialophora verrucosa that led to extensor tendon...
Deep tissue fungal infections of the hand are exceedingly uncommon. We present a case of fungal tenosynovitis caused by Phialophora verrucosa that led to extensor tendon rupture in a patient who was on chronic immunosuppressive therapy. Indolent fungal cysts can elude clinical diagnosis until excision is performed with definitive pathologic examination. In immunocompromised patients, antifungal therapy may be warranted after cyst excision even in the absence of acute infection to prevent subsequent progression to tenosynovitis.
PubMed: 26034457
DOI: 10.1007/s11552-014-9700-4 -
Antimicrobial Agents and Chemotherapy Sep 2014The in vitro activities of nine antifungal drugs and their combinations against 31 clinical and 15 environmental Phialophora verrucosa strains were tested. The MIC90/90%...
The in vitro activities of nine antifungal drugs and their combinations against 31 clinical and 15 environmental Phialophora verrucosa strains were tested. The MIC90/90% minimum effective concentration (MIC/MEC90) values (μg/ml) across all strains were as follows: for terbinafine, 0.25; for posaconazole, 0.5; for voriconazole, 1; for itraconazole, 2; for amphotericin B, 4; for caspofungin and micafungin, 16; and for fluconazole and flucytosine, 64. The highest synergy was shown by the combination of itraconazole plus caspofungin (with synergy against 100% of the 31 clinical strains), followed by amphotericin B plus flucytosine (45.2%) and itraconazole plus terbinafine or micafungin (25.8% or 12.9%, respectively).
Topics: Antifungal Agents; Chromoblastomycosis; Drug Combinations; Microbial Sensitivity Tests; Phialophora
PubMed: 24982078
DOI: 10.1128/AAC.02875-14 -
Journal of Medical and Veterinary... Feb 1986Phialophora verrucosa and P. americana, two dematiaceous hyphomycetes, are known to cause chromoblastomycosis. Even though most medical mycologists consider P. americana... (Comparative Study)
Comparative Study
Phialophora verrucosa and P. americana, two dematiaceous hyphomycetes, are known to cause chromoblastomycosis. Even though most medical mycologists consider P. americana as synonymous with P. verrucosa, others maintain them as two distinct species on the basis that the phialides of P. americana have deeper collarettes than those of P. verrucosa. Thirty-two isolates, identified either as P. americana or P. verrucosa, were studied for their morphologic, physiologic, and antigenic characteristics to evaluate their taxonomic status. Collarette morphology was found to be a variable character in 12 of the 32 isolates. Those 12 produced phialides with both shallow and deep collarettes. All of the isolates hydrolysed urea within 7 days at 25 degrees C, and failed to liquefy gelatin after 3 weeks at 25 degrees C. None of the isolates decomposed casein, xanthine, or hypoxanthine at the end of 3 weeks at 25 degrees C. All decomposed tyrosine. They grew at 25 degrees C and 37 degrees C, but failed to grow at 40 degrees C. The antigenic relationship between the two species was studied by the exoantigen procedure. The 32 isolates showed close antigenic relatedness. Adsorptions of antisera with homologous and heterologous antigens rendered the antisera free of precipitin bands when studied by the microimmunodiffusion test. The depth of phialide collarettes produced by the two species, being found to be variable character, and the identical nature of the two species with respect to their physiologic and antigenic characteristics, led us to conclude that P. americana should be considered as a synonym of P. verrucosa.
Topics: Antigens, Fungal; Immunodiffusion; Phialophora
PubMed: 3084750
DOI: No ID Found -
Mycopathologia Apr 2015Phialophora verrucosa is one of the etiologic agents of chromoblastomycosis, a fungal infection that affects cutaneous and subcutaneous tissues. This disease is chronic,...
Phialophora verrucosa is one of the etiologic agents of chromoblastomycosis, a fungal infection that affects cutaneous and subcutaneous tissues. This disease is chronic, recurrent and difficult to treat. Several studies have shown that secreted peptidases by fungi are associated with important pathophysiological processes. Herein, we have identified and partially characterized the peptidase activity secreted by P. verrucosa conidial cells. Using human serum albumin as substrate, the best hydrolysis profile was detected at extreme acidic pH (3.0) and at 37 °C. The enzymatic activity was completely blocked by classical metallopeptidase inhibitors/chelating agents as 1,10-phenanthroline and EGTA. Zinc ions stimulated the metallo-type peptidase activity in a dose-dependent manner. Several proteinaceous substrates were cleaved, in different extension, by the P. verrucosa metallopeptidase activity, including immunoglobulin G, fibrinogen, collagen types I and IV, fibronectin, laminin and keratin; however, mucin and hemoglobin were not susceptible to proteolysis. As metallopeptidases participate in different cellular metabolic pathways in fungal cells, we also tested the influence of 1,10-phenanthroline and EGTA on P. verrucosa development. Contrarily to EGTA, 1,10-phenanthroline inhibited the fungal viability (MIC 0.8 µg/ml), showing fungistatic effect, and induced profound morphological alterations as visualized by transmission electron microscopy. In addition, 1,10-phenanthroline arrested the filamentation process in P. verrucosa. Our results corroborate the supposition that metallopeptidase inhibitors/chelating agents have potential to control crucial biological events in fungal agents of chromoblastomycosis.
Topics: Antifungal Agents; Fungal Proteins; Humans; Metalloproteases; Mycoses; Phenanthrolines; Phialophora; Protein Translocation Systems; Protein Transport; Spores, Fungal
PubMed: 25502596
DOI: 10.1007/s11046-014-9832-7 -
Cureus Nov 2018Chromoblastomycosis is an implantation mycosis occurring among adults working in farms or with soil in tropical and subtropical areas worldwide. is the most important...
Chromoblastomycosis is an implantation mycosis occurring among adults working in farms or with soil in tropical and subtropical areas worldwide. is the most important agent in the tropical areas, while , although not a predominant agent, is found in the lowlands under the same conditions as the species. We present the case of a 10-year-old aboriginal boy, belonging to a soil worker family, with a history of extensive leg lesions and lymphedema secondary to a snake bite five years earlier. He was admitted to the National Children's Hospital (part of the Caja Costarricense del Seguro Social: the social security system in Costa Rica) with multiple verrucous confluent lesions on the ankle, some with dark coloration, and no other symptoms. Clinical suspicion of chromoblastomycosis was made and later confirmed by culture. Itraconazole was started showing clinical improvement. Chromomycosis, especially in the population with skin lesions or chronic tissue compromise, associated with the location and macroscopic findings, must be a part of our differential diagnosis. The story of an exposed pediatric patient to soil work and the history of an important leg swelling and skin disruption as sequelae of snake bite envenomation made this case unique. To our knowledge, there are no pediatric reports of Chromoblastomycosis in Latin America.
PubMed: 30656078
DOI: 10.7759/cureus.3574 -
The Journal of Medical Research Jul 1915
PubMed: 19972251
DOI: No ID Found