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Case Reports in Infectious Diseases 2022Tetanus has rarely been reported in Thailand since 1982 due to 100% tetanus vaccination coverage during the neonatal period of life. However, the reemergence of tetanus...
BACKGROUND
Tetanus has rarely been reported in Thailand since 1982 due to 100% tetanus vaccination coverage during the neonatal period of life. However, the reemergence of tetanus has been observed in our country during the past decade, mainly due to the increasing number of migrants traveling from neighboring countries in search of work. Acupuncture has become an essential part of alternative and complementary medicine. To our knowledge, acupuncture-associated and infections superimposed by tetanus have never been reported. . A 55-year-old Thai female with schizophrenia was hospitalized due to a 4-day course of trismus, dysphagia, and back muscle spasms. Upon admission, a clinical diagnosis of tetanus was made, which included muscle rigidity and reflex muscle spasms, despite a recent history of diphtheria-tetanus (dT) vaccination for tetanus prophylaxis after 2 episodes of falling complicated by two lacerations on the left shoulder and head. Endotracheal intubation for airway protection was given, in addition to tetanus immunoglobulin, metronidazole, and diazepam which were prescribed to the patient. Incision and drainage of the wound on the left shoulder yielded 40 mL of pus, which subsequently grew species, on anaerobic bacterial, mycobacterial, and fungal cultures, respectively. An incision of an acupuncture wound on the abdominal wall yielded 1 mL of pus, which exhibited positive acid-fast bacilli (AFB) on AFB stain. Mycobacterial culture finally grew . The organism was susceptible to amikacin and clarithromycin. Amikacin, clarithromycin, ciprofloxacin, and voriconazole were then added. The patient gradually improved and was discharged after one month of hospitalization. The patient was reported to be doing well, with no neurological sequelae, when last seen one month after discharge.
CONCLUSIONS
To our knowledge, this is the first case of acupuncture-associated and infections superimposed by tetanus. In Thailand, the occurrence of acupuncture by nonqualified individuals and the reemergence of tetanus remain prevalent. Hence, it is not uncommon to see tetanus in association with acupuncture-related nontuberculous mycobacterial/fungal infection.
PubMed: 35847601
DOI: 10.1155/2022/8918020 -
Medical Mycology Case Reports Mar 2016Infections due Scedosporium spp. in lung transplant recipients are associated with disseminated disease with high mortality rates. The adjunctive local antifungal...
Scedosporium apiospermum and S. prolificans mixed disseminated infection in a lung transplant recipient: An unusual case of long-term survival with combined systemic and local antifungal therapy in intensive care unit.
Infections due Scedosporium spp. in lung transplant recipients are associated with disseminated disease with high mortality rates. The adjunctive local antifungal therapy may be a useful option when systemic treatment is insufficient and/or surgery is not feasible. We present a case of mixed disseminated infection due Scedosporium apiospermum and S. prolificans in a lung transplant recipient. Combined local and systemic antifungal therapy provided an unusual long-term survival in the intensive care unit.
PubMed: 27222774
DOI: 10.1016/j.mmcr.2016.04.006 -
Internal Medicine (Tokyo, Japan) Sep 2023
Topics: Humans; Scedosporium; Antifungal Agents
PubMed: 36642520
DOI: 10.2169/internalmedicine.1074-22 -
Brazilian Journal of Microbiology :... Mar 2021Cystic fibrosis (CF) causes a variety of symptoms in different organs, but the majority of the morbidity and mortality of CF is related with pulmonary conditions....
Cystic fibrosis (CF) causes a variety of symptoms in different organs, but the majority of the morbidity and mortality of CF is related with pulmonary conditions. Primary infections are usually bacterial, and when treated with antibiotics, yeast infections appear or become more evident. Studies show that different microorganisms can co-inhabit the same environment and the interactions could be synergistic or antagonistic. Using techniques including viable and non-viable cell-to-cell interactions, mixed culture in liquid, and solid media sharing or not the supernatant, this study has evaluated interactions between the fungal species Scedosporium apiospermum and Scedosporium boydii with the bacterial species Staphylococcus aureus, Pseudomonas aeruginosa, and Burkholderia cepacia. Cell-to-cell interactions in liquid medium showed that P. aeruginosa and B. cepacia were able to reduce fungal viability but only in the presence of alive bacteria. Interactions without cell contact using a semi-permeable membrane showed that all bacteria were able to inhibit both fungal growths/viabilities. Cell-free supernatants from bacterial growth reduced fungal viability in planktonic fungal cells as well as in some conditions for preformed fungal biomass. According to the chemical analysis of the bacterial supernatants, the predominant component is protein. In this work, we verified that bacterial cells and their metabolites, present in the supernatants, can play anti-S. apiospermum and anti-S. boydii roles on fungal growth and viability.
Topics: Cystic Fibrosis; Humans; Microbial Viability; Mycoses; Pseudomonas aeruginosa; Scedosporium; Staphylococcus aureus
PubMed: 33442865
DOI: 10.1007/s42770-020-00415-w -
Indian Journal of Dermatology 2019Disseminated infection with is an emerging opportunistic infection in immunocompromised individuals. A 41-year-old male farmer presented with a diffuse swelling in the...
Disseminated infection with is an emerging opportunistic infection in immunocompromised individuals. A 41-year-old male farmer presented with a diffuse swelling in the right foot with discharge of whitish material from the swelling for 1 year. He also had multiple cystic swellings of varying sizes in the right ankle, left leg, left foot, and right forearm for 6 months. There was a history of diabetes and steroid therapy for joint pain which had increased the risk of dissemination of fungi in our patient. Early recognition of this infection and treating the patients with systemic antifungal drugs such as voriconazole and local surgical debridement help in resolution of the lesion.
PubMed: 31516142
DOI: 10.4103/ijd.IJD_332_18 -
Antimicrobial Agents and Chemotherapy Oct 2014Scedosporium species show decreased susceptibility to the majority of systemic antifungal drugs. Acquired resistance is likely to disseminate differentially with the...
Scedosporium species show decreased susceptibility to the majority of systemic antifungal drugs. Acquired resistance is likely to disseminate differentially with the mode of exchange of genetic material between lineages. Inter- and intraspecific diversities of Scedosporium species were analyzed for three partitions (rDNA internal transcribed spacer gene [ITS], partial β-tubulin gene, and amplified fragment length polymorphism profiles), with the aim to establish distribution of resistance between species, populations, and strains. Heterogeneity of and recombination between lineages were determined, and distances between clusters were calculated using a centroid approach. Clinical, geographic, and antifungal data were plotted on diversity networks. Scedosporium minutisporum, Scedosporium desertorum, and Scedosporium aurantiacum were distinguished unambiguously in all partitions and had differential antifungal susceptibility profiles (ASP). Pseudallescheria fusoidea and Pseudallescheria ellipsoidea were indistinguishable from Scedosporium boydii. Pseudallescheria angusta took an intermediate position between Scedosporium apiospermum and S. boydii. Scedosporium boydii and S. apiospermum had identical ASP. Differences in (multi)resistance were linked to individual strains. S. apiospermum and S. boydii showed limited interbreeding and were recognized as valid, sympatric species. The S. apiospermum/S. boydii group, comprising the main clinically relevant Scedosporium species, consists of separate lineages and is interpreted as a complex undergoing sympatric evolution with incomplete lineage sorting. In routine diagnostics, the lineages in S. apiospermum/S. boydii are indicated with the umbrella descriptor "S. apiospermum complex"; individual species can be identified with rDNA ITS with 96.3% confidence. Voriconazole is recommended as the first-line treatment; resistance against this compound is rare.
Topics: Antifungal Agents; Pseudallescheria; Scedosporium; Voriconazole
PubMed: 25070092
DOI: 10.1128/AAC.03211-14 -
Antimicrobial Agents and Chemotherapy Oct 2004Invasive infection due to Scedosporium prolificans is characterized by drug resistance and a high rate of mortality. The effects of posaconazole (POS), an...
Antifungal activities of posaconazole and granulocyte-macrophage colony-stimulating factor ex vivo and in mice with disseminated infection due to Scedosporium prolificans.
Invasive infection due to Scedosporium prolificans is characterized by drug resistance and a high rate of mortality. The effects of posaconazole (POS), an investigational antifungal triazole, murine granulocyte-macrophage colony-stimulating factor (GM-CSF), and their combination against S. prolificans were evaluated ex vivo and in a newly developed murine model of disseminated infection due to this organism. When POS was combined with polymorphonuclear leukocytes from untreated or GM-CSF-treated mice (P < 0.01) ex vivo, it had increased activity in terms of the percentage of hyphal damage. Immunocompetent BALB/c mice were infected with 4 x 10(4) conidia of S. prolificans via the lateral tail vein. At 24 h postinfection the mice were treated with GM-CSF (5 microg/kg of body weight/day subcutaneously), POS (50 mg/kg/day by gavage), both agents, or saline only. Half of the brain, lung, liver, and kidney from each animal were cultured; and the other half of each organ was processed for histopathology. The mean survival times were 7.0 +/- 0.3 days for the controls, 7.4 +/- 0.4 days for POS-treated mice, 8.0 +/- 0.3 days for GM-CSF-treated mice (P = 0.08 compared with the results for the controls), and 7.3 +/- 0.3 days for POS-GM-CSF-treated mice. Fungal burdens (determined as the numbers of CFU per gram of tissue) were found in descending orders of magnitude in the kidneys, brains, livers, and lungs. The burdens were significantly reduced in the brains of GM-CSF-treated mice (P < 0.05) and the livers of POS-treated mice (P < 0.05). The numbers of lesions in the organs closely corresponded to the fungal burdens. GM-CSF tended to prolong survival (P = 0.08 compared with the results for the controls). While the combination of POS and GM-CSF showed enhanced activity ex vivo, it did not increase the activities of the two agents against this highly refractory filamentous fungus in mice.
Topics: Animals; Antifungal Agents; Brain; Drug Resistance, Fungal; Female; Granulocyte-Macrophage Colony-Stimulating Factor; Kidney; Liver; Male; Mice; Mice, Inbred BALB C; Microbial Sensitivity Tests; Mycetoma; Organ Culture Techniques; Scedosporium; Survival Analysis; Triazoles
PubMed: 15388437
DOI: 10.1128/AAC.48.10.3801-3805.2004 -
Medical Mycology Case Reports Apr 2014Scedosporium prolificans are opportunistic moulds that can cause mycetoma following penetrating injuries. This fungus is more virulent than other species and treatment...
Scedosporium prolificans are opportunistic moulds that can cause mycetoma following penetrating injuries. This fungus is more virulent than other species and treatment options are limited. Here we describe the first known case in the UK of S. prolificans osteomyelitis, in a 4 year old following penetrating injury. Successful outcome with limb salvage and foot function is achieved after repeated surgical debridement, and combination chemotherapy with voriconazole/terbinafine.
PubMed: 24855598
DOI: 10.1016/j.mmcr.2014.03.002 -
Microbial Cell (Graz, Austria) Jun 2014is a pathogenic mold resistant to current antifungals, and infection results in high mortality. Simultaneous targeting of both ergosterol biosynthesis and heat shock...
is a pathogenic mold resistant to current antifungals, and infection results in high mortality. Simultaneous targeting of both ergosterol biosynthesis and heat shock protein 90 (Hsp90) or the calcineurin pathway in may be an important strategy for enhancing the potency of antifungal agents. We hypothesized that the inactive triazoles posaconazole (PCZ) and itraconazole (ICZ) acquire fungicidal activity when combined with the calcineurin inhibitor tacrolimus (TCR) or Hsp90 inhibitor 17-demethoxy-17-(2-propenylamino) geldanamycin (17AAG). PCZ, ICZ, TCR and 17AAG alone were inactive against spores (MICs > 128 μg/ml). In contrast, MICs for PCZ or ICZ in combination with TCR or 17AAG (0.125-0.50 μg/ml) were much lower compared with drug alone. In addition PCZ and ICZ in combination with TCR or 17AAG became fungicidal. Because apoptosis is regulated by the calcineurin pathway in fungi and is under the control of Hsp90, we hypothesized that this synergistic fungicidal effect is mediated via apoptosis. This observed fungicidal activity was mediated by increased apoptosis of germlings, as evidenced by reactive oxygen species accumulation, decreased mitochondrial membrane potential, phosphatidylserine externalization, and DNA fragmentation. Furthermore, induction of caspase-like activity was correlated with TCR or 17AAG + PCZ/ICZ-induced cell death. In conclusion, we report for the first time that PCZ or ICZ in combination with TCR or 17AAG renders exquisitely sensitive to PCZ or ICZ via apoptosis. This finding may stimulate the development of new therapeutic strategies for patients infected with this recalcitrant fungus.
PubMed: 28357242
DOI: 10.15698/mic2014.06.150 -
Frontiers in Cellular and Infection... 2020The detection and diagnosis of the opportunistic fungi spp. and still relies mainly on low-sensitive culture-based methods. This fact is especially worrying in Cystic...
The detection and diagnosis of the opportunistic fungi spp. and still relies mainly on low-sensitive culture-based methods. This fact is especially worrying in Cystic Fibrosis (CF) patients in whom these fungal species are frequently isolated and may increase the risk of suffering from an infection or other health problems. Therefore, with the purpose of developing a serologic detection method for /, four different protein extracts (whole cell protein extract, secretome, total cell surface and conidial surface associated proteins) were studied by ELISA to select the most useful for IgG detection in sera from CF patients. The four extracts were able to discriminate the /-infected from infected and non-infected patients. However, the whole cell protein extract was the one selected, as it was the one with the highest output in terms of protein concentration per ml of fungal culture used, and its discriminatory capacity was the best. The ELISA test developed was then assayed with 212 sera from CF patients and it showed to be able to detect spp. and with very high sensitivity and specificity, 86%-100% and 93%-99%, respectively, depending on the cut-off value chosen (four values were proposed A= 0.5837, A= 0.6042, A= 0.6404, and A= 0.7099). Thus, although more research is needed to reach a standardized method, this ELISA platform offers a rapid, low-cost and easy solution to detect these elusive fungi through minimally invasive sampling, allowing the monitoring of the humoral response to fungal presence.
Topics: Antifungal Agents; Ascomycota; Cystic Fibrosis; Enzyme-Linked Immunosorbent Assay; Humans; Scedosporium
PubMed: 33324582
DOI: 10.3389/fcimb.2020.602089