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Journal of Clinical Pathology Oct 1996To evaluate the performance of an immunoperoxidase stain using the monoclonal antibody EB-A1 to detect Aspergillus species in formalin fixed, paraffin wax embedded... (Comparative Study)
Comparative Study
AIMS
To evaluate the performance of an immunoperoxidase stain using the monoclonal antibody EB-A1 to detect Aspergillus species in formalin fixed, paraffin wax embedded tissue.
METHODS
The monoclonal antibody EB-A1 directed against galactomannan was used to detect Aspergillus species in 23 patients with suspected or confirmed invasive aspergillosis. Immunostaining was performed on formalin fixed, paraffin wax embedded tissue using the streptavidin-biotin method and compared with conventional haematoxylin and eosin, periodic acid-Schiff, and Gomori-Grocott stains. Results of immunostaining were semiquantitatively analysed with regard to both intensity of staining and number of positively staining micro-organisms. Tissue sections from 16 patients with confirmed invasive mycoses due to Candida species, Apophysomyces elegans, Rhizopus oryzae, Pseudallescheria boydii and Histoplasma capsulatum were used as controls.
RESULTS
In 19 (83%) of 23 cases invasive aspergillosis was confirmed by both histological examination and culture (18 Aspergillus fumigatus and one A flavus). Immunoperoxidase stains were positive in 17 (89%) of 19 cases including one case of disseminated infection due to A flavus. Furthermore, the immunoperoxidase stain was positive in a culture negative tissue section with histological evidence of mycelial development, indicating the presence of Aspergillus species. Some cross-reactivity was observed with the highly related fungus P boydii, although the number of mycelial elements that stained was low.
CONCLUSIONS
Immunoperoxidase staining using the monoclonal antibody EB-A1 performs well on routinely processed tissue sections and permits detection and generic identification of Aspergillus species, although it was no better than conventional histopathology in identifying the presence of an infection. An additional advantage is that the immunostain may help to provide an aetiological diagnosis when cultures remain negative.
Topics: Adolescent; Adult; Aged; Aspergillosis; Aspergillus flavus; Aspergillus fumigatus; Child; Female; Humans; Immunoenzyme Techniques; Infant; Male; Middle Aged; Sensitivity and Specificity
PubMed: 8943743
DOI: 10.1136/jcp.49.10.798 -
The Indian Journal of Medical Research Jun 2010Zygomycosis is highly invasive fungal infection, with high mortality rate. In most of patients, diabetes mellitus is an underlying factor but in primary cutaneous...
BACKGROUND & OBJECTIVES
Zygomycosis is highly invasive fungal infection, with high mortality rate. In most of patients, diabetes mellitus is an underlying factor but in primary cutaneous zygomycosis, presentation may be different. Here we present the description of clinical presentation, fungi isolated and management of cases with cutaneous zygomycosis seen in a tertiary care hospital in north India during 2001-2007.
METHODS
All patients diagnosed with primary cutaneous zygomycosis between November 2001 and September 2007 presenting with clinical diagnosis of necrotizing fasciitis were included. Detailed history of each patient was taken, clinical presentation, site of involvement, underlying illness and risk factor, if any were noted. The diagnosis was established by direct microscopic evidence of broad, aseptate or sparsely septate ribbon-like hyphae with right angle branching in KOH wet mount and histopathological examination of stained sections. Cultures were put up for fungal isolation and species identification. Outcome of the therapy was analysed.
RESULTS
Of the nine patients reviewed, only one had diabetes mellitus. Commonest risk factor was injection abscess (33.3%). Apophysomyces elegans was isolated in four cases, Saksenaea vasiformis and Absidia corymbifera in one each. The fungal culture was sterile in three cases. Mortality rate was high with only four patients responded well to surgical and/or medical therapy.
INTERPRETATION & CONCLUSION
Primary cutaneous zygomycosis appears to be on rise in India that calls for high index of clinical suspicion and an early biopsy of the affected area for timely diagnosis. The standard treatment is a combination of amphotericin B therapy, surgical debridement, and reversal of the underlying disease or immunosuppression.
Topics: Adult; Aged, 80 and over; Dermatomycoses; Female; Hospitals; Humans; India; Male; Middle Aged; Mucorales; Risk Factors; Young Adult; Zygomycosis
PubMed: 20571164
DOI: No ID Found -
Journal of Clinical Microbiology May 2007We report a case of rhino-orbital zygomycosis in a 43-year-old male with well-controlled diabetes mellitus. The patient initially received liposomal amphotericin B, but...
We report a case of rhino-orbital zygomycosis in a 43-year-old male with well-controlled diabetes mellitus. The patient initially received liposomal amphotericin B, but the infection continued to progress, so posaconazole treatment was begun and eventually led to the cure of his infection. The causative agent was identified as Apophysomyces elegans, an emerging cause of zygomycosis in immunocompetent hosts.
Topics: Adult; Antifungal Agents; Dermatomycoses; Diabetes Mellitus; Fungi; Humans; Male; Triazoles; Zygomycosis
PubMed: 17344359
DOI: 10.1128/JCM.00014-07 -
Medical Mycology Case Reports Oct 2014Skin and soft tissue fungal infections with Apophysomyces elegans, Fusarium solani, Cladophialophora bantiana have been reported in survivors from 2004 Indian ocean...
Skin and soft tissue fungal infections with Apophysomyces elegans, Fusarium solani, Cladophialophora bantiana have been reported in survivors from 2004 Indian ocean Tsunami. We report the first case of primary cutaneous cryptococcosis caused by Cryptococcus gattii VGII in a Tsunami survivor from Thailand.
PubMed: 25379396
DOI: 10.1016/j.mmcr.2014.08.005