Journal de mycologie medicale最新文献

英文中文

Head skin infection by Candida auris: A case report

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale

Pub Date : 2025-03-18 DOI: 10.1016/j.mycmed.2025.101544

Jueting Tang, Kaiying Yang, Zhixin Cui, Yanhong Guan, Zelun Li

Background

Candida auris is a recently discovered yeast species first found in 2009 in the ear discharge of a patient in Japan. Known for its high mortality rate, strong transmissibility, ability to cause hospital outbreaks, and resistance to multiple drugs, it has earned the nickname "superbug". Currently, there are five main clades of Candida auris identified, including the South Asian, East Asian, South African, South American, and a newly discovered fifth clade in Iran. Infection cases have been documented in over 40 countries across six continents, drawing global attention. In 2022, the World Health Organization (WHO) designated Candida auris as a top priority pathogen in their inaugural list of fungal threats to health. The lack of standardized and effective treatment protocols and prevention strategies has resulted in numerous treatment and control failures. To delve deeper into the clinical management strategies and hospital infection control measures for Candida auris, we conducted a retrospective analysis of a Candida auris infection case and briefly reviewed relevant literature.

Case presentation

A 54-year-old male patient with a complex medical history developed a Candida auris infection, presenting with ulcerative scalp lesions. The medical team implemented local wound care measures, including iodophor disinfection and infrared therapy, and strictly adhered to the hospital's infection control protocols, successfully controlling the Candida auris infection without any nosocomial transmission.

Conclusion

This case study highlights the importance of individualized treatment and tailored infection control measures implemented through interdisciplinary teamwork. The successful management underscores the potential for containing the spread of Candida auris, offering valuable insights for future strategies against this emerging multidrug-resistant pathogen. However, the complex challenges in diagnosing, treating, and controlling Candida auris infections emphasize the imperative need to enhance research and establish standardized protocols.

{"title":"Head skin infection by Candida auris: A case report","authors":"Jueting Tang, Kaiying Yang, Zhixin Cui, Yanhong Guan, Zelun Li","doi":"10.1016/j.mycmed.2025.101544","DOIUrl":"10.1016/j.mycmed.2025.101544","url":null,"abstract":"<div><h3>Background</h3><div><em>Candida auris</em> is a recently discovered yeast species first found in 2009 in the ear discharge of a patient in Japan. Known for its high mortality rate, strong transmissibility, ability to cause hospital outbreaks, and resistance to multiple drugs, it has earned the nickname \"superbug\". Currently, there are five main clades of <em>Candida auris</em> identified, including the South Asian, East Asian, South African, South American, and a newly discovered fifth clade in Iran. Infection cases have been documented in over 40 countries across six continents, drawing global attention. In 2022, the World Health Organization (WHO) designated <em>Candida auris</em> as a top priority pathogen in their inaugural list of fungal threats to health. The lack of standardized and effective treatment protocols and prevention strategies has resulted in numerous treatment and control failures. To delve deeper into the clinical management strategies and hospital infection control measures for Candida auris, we conducted a retrospective analysis of a <em>Candida auris</em> infection case and briefly reviewed relevant literature.</div></div><div><h3>Case presentation</h3><div>A 54-year-old male patient with a complex medical history developed a <em>Candida auris</em> infection, presenting with ulcerative scalp lesions. The medical team implemented local wound care measures, including iodophor disinfection and infrared therapy, and strictly adhered to the hospital's infection control protocols, successfully controlling the <em>Candida auris</em> infection without any nosocomial transmission.</div></div><div><h3>Conclusion</h3><div>This case study highlights the importance of individualized treatment and tailored infection control measures implemented through interdisciplinary teamwork. The successful management underscores the potential for containing the spread of Candida auris, offering valuable insights for future strategies against this emerging multidrug-resistant pathogen. However, the complex challenges in diagnosing, treating, and controlling <em>Candida auris</em> infections emphasize the imperative need to enhance research and establish standardized protocols.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101544"},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disseminated infection with Candida dubliniensis after ravulizumab and treatment with rezafungin – a case report

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale

Pub Date : 2025-03-16 DOI: 10.1016/j.mycmed.2025.101545

Felix Lötsch , Michael Eder , Haris Omic , Konstantin Doberer , Martina Scharitzer , Matthias G. Vossen , Gabriella Muraközy , Birgit Willinger , Christof Aigner

引用次数: 0

Fungal microbiota in COPD patients during exacerbations

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale

Pub Date : 2025-03-10 DOI: 10.1016/j.mycmed.2025.101543

Weronika Gawor , Katarzyna Góralska , Sandra Galant , Sebastian Majewski , Wojciech Piotrowski , Joanna Miłkowska-Dymanowska , Justyna Kiszałkiewicz , Ewa Brzeziańska-Lasota

Acute exacerbations of chronic obstructive pulmonary disease (COPD) results in increased mortality and can be triggered by a range of factors, including microorganisms. Very little studies have examined the role of fungi and fungal diversity in COPD patients. The aim of the study was to determine the role of Candida in COPD during an exacerbation. Oral swabs, sputum, feces and whole blood samples were collected from the AECOPD patients and control group. Mycological and serological analysis were performed. Yeast were statistically significantly more often isolated from the AECOPD group (97.06%) than from the control group (26.32%). 7 species were isolated from the AECOPD, and 3 from the control group. Dominated Candida albicans followed by C. tropicalis. α-diversity was much greater in AECOPD patients than in controls. β-diversity was also assessed. A much higher level of antimycotic resistance was observed in isolates from the AECOPD group, which affects the effectiveness of therapy. Serological tests showed twice the frequency of positive results in the AECOPD group. The mycobiota of AECOPD patients is numerically and taxonomically richer than controls, including species less frequently recorded in humans. Our research confirms that fungal mycobiota may be a potential factor influencing the development of exacerbations and progression of COPD.

{"title":"Fungal microbiota in COPD patients during exacerbations","authors":"Weronika Gawor , Katarzyna Góralska , Sandra Galant , Sebastian Majewski , Wojciech Piotrowski , Joanna Miłkowska-Dymanowska , Justyna Kiszałkiewicz , Ewa Brzeziańska-Lasota","doi":"10.1016/j.mycmed.2025.101543","DOIUrl":"10.1016/j.mycmed.2025.101543","url":null,"abstract":"<div><div>Acute exacerbations of chronic obstructive pulmonary disease (COPD) results in increased mortality and can be triggered by a range of factors, including microorganisms. Very little studies have examined the role of fungi and fungal diversity in COPD patients. The aim of the study was to determine the role of <em>Candida</em> in COPD during an exacerbation. Oral swabs, sputum, feces and whole blood samples were collected from the AECOPD patients and control group. Mycological and serological analysis were performed. Yeast were statistically significantly more often isolated from the AECOPD group (97.06%) than from the control group (26.32%). 7 species were isolated from the AECOPD, and 3 from the control group. Dominated <em>Candida albicans</em> followed by <em>C. tropicalis</em>. α-diversity was much greater in AECOPD patients than in controls. β-diversity was also assessed. A much higher level of antimycotic resistance was observed in isolates from the AECOPD group, which affects the effectiveness of therapy. Serological tests showed twice the frequency of positive results in the AECOPD group. The mycobiota of AECOPD patients is numerically and taxonomically richer than controls, including species less frequently recorded in humans. Our research confirms that fungal mycobiota may be a potential factor influencing the development of exacerbations and progression of COPD.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 2","pages":"Article 101543"},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acknowledging our reviewers

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale

Pub Date : 2025-03-01 DOI: 10.1016/S1156-5233(25)00010-1

引用次数: 0

Investigation of a dermatophytosis outbreak in a kindergarten in Doubs, France, June 2022

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale

Pub Date : 2025-02-05 DOI: 10.1016/j.mycmed.2025.101537

Sabrina Tessier , Dominique Cailly , Anne-Pauline Bellanger , Emeline Scherer , Isabelle Lucot , Lauriane Szpakowski-Perrot , Rachel Daveau , Camille Chapulliot , Evelyne Simon-Rose , Antoine Journé , Mélina Renard , Nadia Gharet , François Clinard , Marie Barba-Vasseur

Background

Microsporum audouinii, an anthropophilic dermatophyte has recently reemerged in several European countries (such as France).

Aim

To describe the epidemiological and microbiological investigations into several reported cases of dermatophytosis to the public health authorities in May 2022 in a kindergarten in the Doubs department (eastern France).

Methods

All children with clinical signs underwent a clinical examination and mycological investigation of skin or scalp samples taken onsite at the kindergarten. Several diagnosis methods were used: Wood's lamp examination, classical process (direct examination associated to culture) and molecular techniques. An epidemiological survey by questionnaire was also performed to collect individual exposure data.

Results

Fifteen children presented lesions during the clinical examination. Therapy was prescribed for nine children based on the 2021 recommendations of the French Society of Dermatology. Microsporum canis was initially diagnosed by the classical process. This identification was not confirmed by epidemiological information (absence of direct contact with animals) and molecular techniques. Finally, Microsporum audouinii was isolated in six children (two positive Wood's lamp examinations) and one staff member.

Conclusion

Species identification allowed us to (1) update the therapeutic strategy (all children were treated successfully) and (2) be more vigilant regarding the risk of human-to-human transmissions. The management of intrafamilial transmissions requires collaboration with healthcare practitioners to clinically examine family members, prescribe laboratory investigations, and reiterate the hygiene measures. This study confirmed the importance of combining field epidemiological investigations and microbiological examinations when managing dermatophytosis outbreaks.

{"title":"Investigation of a dermatophytosis outbreak in a kindergarten in Doubs, France, June 2022","authors":"Sabrina Tessier , Dominique Cailly , Anne-Pauline Bellanger , Emeline Scherer , Isabelle Lucot , Lauriane Szpakowski-Perrot , Rachel Daveau , Camille Chapulliot , Evelyne Simon-Rose , Antoine Journé , Mélina Renard , Nadia Gharet , François Clinard , Marie Barba-Vasseur","doi":"10.1016/j.mycmed.2025.101537","DOIUrl":"10.1016/j.mycmed.2025.101537","url":null,"abstract":"<div><h3>Background</h3><div><em>Microsporum audouinii</em>, an anthropophilic dermatophyte has recently reemerged in several European countries (such as France).</div></div><div><h3>Aim</h3><div>To describe the epidemiological and microbiological investigations into several reported cases of dermatophytosis to the public health authorities in May 2022 in a kindergarten in the Doubs department (eastern France).</div></div><div><h3>Methods</h3><div>All children with clinical signs underwent a clinical examination and mycological investigation of skin or scalp samples taken onsite at the kindergarten. Several diagnosis methods were used: Wood's lamp examination, classical process (direct examination associated to culture) and molecular techniques. An epidemiological survey by questionnaire was also performed to collect individual exposure data.</div></div><div><h3>Results</h3><div>Fifteen children presented lesions during the clinical examination. Therapy was prescribed for nine children based on the 2021 recommendations of the French Society of Dermatology. <em>Microsporum canis</em> was initially diagnosed by the classical process. This identification was not confirmed by epidemiological information (absence of direct contact with animals) and molecular techniques. Finally, <em>Microsporum audouinii</em> was isolated in six children (two positive Wood's lamp examinations) and one staff member.</div></div><div><h3>Conclusion</h3><div>Species identification allowed us to (1) update the therapeutic strategy (all children were treated successfully) and (2) be more vigilant regarding the risk of human-to-human transmissions. The management of intrafamilial transmissions requires collaboration with healthcare practitioners to clinically examine family members, prescribe laboratory investigations, and reiterate the hygiene measures. This study confirmed the importance of combining field epidemiological investigations and microbiological examinations when managing dermatophytosis outbreaks.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 1","pages":"Article 101537"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The first autochthonous human case of sporotrichosis by Sporothrix brasiliensis in Paraguay

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale

Pub Date : 2025-02-04 DOI: 10.1016/j.mycmed.2025.101536

Mirtha Gabriela Santacruz Silvero , Carolina Melchior do Prado , Bram Spruijtenburg , Federico Augusto Lacarrubba Codas , Maria Leticia Ojeda , Bruna Jacomel Favoreto de Souza Lima , Nancy Segovia Coronel , José Pereira Brunelli , Vânia Aparecida Vicente , Theun de Groot , Flávio Queiroz-Telles , Eelco F.J. Meijer

Sporotrichosis by Sporothrix brasiliensis is increasingly reported in South America. Here, we present the first autochthonous human case in Paraguay, transmitted by a local infected cat. After 63 days of clinical signs onset, the patient was correctly diagnosed and antifungal treatment started, highlighting the need to increase awareness for this emerging disease.

引用次数: 0

Bloodstream infection in a neonatal intensive care unit: Epidemiology, Antifungal susceptibility and new drug delivered strategies

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale

Pub Date : 2025-01-18 DOI: 10.1016/j.mycmed.2025.101535

Matheus Ribeiro , Luciana da Silva Ruiz , Rinaldo Ferreira Gandra , Rubiana Mara Mainardes , Carine Teles Sangaleti Miyahara , Débora Moreira , Maurício Domingues-Ferreira , Diniz Pereira Leite Junior , Claudete Rodrigues Paula , Marcos Ereno Auler

Bloodstream infection in neonates is a complicated disease and presents a major challenge both in diagnosis and in therapeutic intervention. The focus of the present study was to investigate the incidence, the species distribution and the risk factors associated with mortality of bloodstream infections in a neonatal intensive care unit (NICU) and evaluating the antifungal susceptibility of traditional antifungal drugs and three nanoparticle-based drug delivery systems based on nanoparticles. A total of 458 patients were evaluated, and 9.38 % were confirmed to have bloodstream infections through laboratory tests. The death rate was higher among neonates with fungal infections (66.7 %) compared to those with bacterial infections (5.4 %). Severe health conditions contributed to the increased mortality rate, especially gestational age <28 weeks and weight <1.000 g. Coagulase-negative staphylococci were the major pathogens (64.9 %) considering cases of neonatal sepsis. Candida albicans was the predominant causative agent among neonates with fungemia, although non-albicans species led to the highest mortality rates. In vitro antifungal activity evidenced resistance of C. tropicalis to fluconazole and voriconazole. Three nanoparticles were evaluated: chitosan-coated PLGA containing Amphotericin B, zein containing voriconazole and PLA containing voriconazole, and results were considered promising. The present findings demonstrate the importance of constant epidemiological surveillance in a NICU and the severity of fungal infection in neonates. The results suggest the potential of nanotechnology as an alternative in the treatment of fungal infection.

{"title":"Bloodstream infection in a neonatal intensive care unit: Epidemiology, Antifungal susceptibility and new drug delivered strategies","authors":"Matheus Ribeiro , Luciana da Silva Ruiz , Rinaldo Ferreira Gandra , Rubiana Mara Mainardes , Carine Teles Sangaleti Miyahara , Débora Moreira , Maurício Domingues-Ferreira , Diniz Pereira Leite Junior , Claudete Rodrigues Paula , Marcos Ereno Auler","doi":"10.1016/j.mycmed.2025.101535","DOIUrl":"10.1016/j.mycmed.2025.101535","url":null,"abstract":"<div><div>Bloodstream infection in neonates is a complicated disease and presents a major challenge both in diagnosis and in therapeutic intervention. The focus of the present study was to investigate the incidence, the species distribution and the risk factors associated with mortality of bloodstream infections in a neonatal intensive care unit (NICU) and evaluating the antifungal susceptibility of traditional antifungal drugs and three nanoparticle-based drug delivery systems based on nanoparticles. A total of 458 patients were evaluated, and 9.38 % were confirmed to have bloodstream infections through laboratory tests. The death rate was higher among neonates with fungal infections (66.7 %) compared to those with bacterial infections (5.4 %). Severe health conditions contributed to the increased mortality rate, especially gestational age <em><</em>28 weeks and weight <em><</em>1.000 g. Coagulase-negative staphylococci were the major pathogens (64.9 %) considering cases of neonatal sepsis. <em>Candida albicans</em> was the predominant causative agent among neonates with fungemia, although non-<em>albicans</em> species led to the highest mortality rates. <em>In vitro</em> antifungal activity evidenced resistance of <em>C. tropicalis</em> to fluconazole and voriconazole. Three nanoparticles were evaluated: chitosan-coated PLGA containing Amphotericin B, zein containing voriconazole and PLA containing voriconazole, and results were considered promising. The present findings demonstrate the importance of constant epidemiological surveillance in a NICU and the severity of fungal infection in neonates. The results suggest the potential of nanotechnology as an alternative in the treatment of fungal infection.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 1","pages":"Article 101535"},"PeriodicalIF":2.2,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An unexpected guest: First report of Tintelnotia destructans as an agent of maxillary fungus ball

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale

Pub Date : 2025-01-17 DOI: 10.1016/j.mycmed.2025.101533

Jacques Sevestre , Justin Michel , Romain Appay , Stéphane Ranque , Thomas Radulesco , Carole Cassagne

Fungal rhinosinusal infections comprise several nosological entities, including sinus fungus ball. Diagnosis of sinus fungus ball relies on patient interrogation and clinical and paraclinical findings. Mold species commonly involved include Aspergillus, as well as dematiaceous fungi. Nevertheless, thanks to improvements in fungal culture and species level identification in clinical settings, new species are continuously described as agents in rhinosinusal infections. We present the first report of Tintelnotia destructans causing maxillary sinus fungus ball in a female patient.

引用次数: 0

Ibrexafungerp for the treatment of vulvovaginal candidiasis: A systematic review and meta-analysis of randomized placebo-controlled trials

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale

Pub Date : 2025-01-16 DOI: 10.1016/j.mycmed.2025.101534

Chia Siang Kow , Dinesh Sangarran Ramachandram , Syed Shahzad Hasan , Kaeshaelya Thiruchelvam

Introduction

Vulvovaginal candidiasis (VVC) is a prevalent fungal infection affecting millions of women globally, primarily caused by Candida species, most notably Candida albicans. Ibrexafungerp emerges as a promising candidate in the treatment arsenal against VVC, presenting a novel approach to combating this prevalent fungal infection.

Methods

A systematic literature search was conducted across major databases, including PubMed, EMBASE, and the Cochrane Library, to identify relevant randomized controlled trials (RCTs) evaluating the efficacy and safety of ibrexafungerp in the treatment of VVC. Following rigorous methodology, data extraction, risk of bias assessment using Cochrane's RoB 2 tool, and meta-analysis were conducted.

Results

Four RCTs were included in the analyses. The ibrexafungerp regimen utilized across the studies were 300 mg administered twice daily for one day. Meta-analysis revealed that ibrexafungerp was associated with significantly higher clinical cure rates compared to placebo in patients with VVC (pooled odds ratio (OR) 2.32; 95 % confidence interval (CI) 1.80 to 2.98). Complete symptom resolution was achieved in a greater proportion of participants receiving ibrexafungerp (pooled OR 2.76; 95 % CI 1.62 to 4.71). Analysis of treatment-emergent adverse events revealed a significant higher incidence of at least one treatment-emergent adverse event with ibrexafungerp compared to placebo (pooled OR 2.83; 95 % CI 2.06 to 3.88).

Conclusion

This study provides robust support for the efficacy of ibrexafungerp in the treatment of VVC. While the safety profile of ibrexafungerp appears favorable with mostly mild adverse events reported, decision-making in the clinical context should be guided by individual patient factors.

{"title":"Ibrexafungerp for the treatment of vulvovaginal candidiasis: A systematic review and meta-analysis of randomized placebo-controlled trials","authors":"Chia Siang Kow , Dinesh Sangarran Ramachandram , Syed Shahzad Hasan , Kaeshaelya Thiruchelvam","doi":"10.1016/j.mycmed.2025.101534","DOIUrl":"10.1016/j.mycmed.2025.101534","url":null,"abstract":"<div><h3>Introduction</h3><div>Vulvovaginal candidiasis (VVC) is a prevalent fungal infection affecting millions of women globally, primarily caused by <em>Candida</em> species, most notably <em>Candida albicans</em>. Ibrexafungerp emerges as a promising candidate in the treatment arsenal against VVC, presenting a novel approach to combating this prevalent fungal infection.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted across major databases, including PubMed, EMBASE, and the Cochrane Library, to identify relevant randomized controlled trials (RCTs) evaluating the efficacy and safety of ibrexafungerp in the treatment of VVC. Following rigorous methodology, data extraction, risk of bias assessment using Cochrane's RoB 2 tool, and meta-analysis were conducted.</div></div><div><h3>Results</h3><div>Four RCTs were included in the analyses. The ibrexafungerp regimen utilized across the studies were 300 mg administered twice daily for one day. Meta-analysis revealed that ibrexafungerp was associated with significantly higher clinical cure rates compared to placebo in patients with VVC (pooled odds ratio (OR) 2.32; 95 % confidence interval (CI) 1.80 to 2.98). Complete symptom resolution was achieved in a greater proportion of participants receiving ibrexafungerp (pooled OR 2.76; 95 % CI 1.62 to 4.71). Analysis of treatment-emergent adverse events revealed a significant higher incidence of at least one treatment-emergent adverse event with ibrexafungerp compared to placebo (pooled OR 2.83; 95 % CI 2.06 to 3.88).</div></div><div><h3>Conclusion</h3><div>This study provides robust support for the efficacy of ibrexafungerp in the treatment of VVC. While the safety profile of ibrexafungerp appears favorable with mostly mild adverse events reported, decision-making in the clinical context should be guided by individual patient factors.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 1","pages":"Article 101534"},"PeriodicalIF":2.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disseminated histoplasmosis in a 4-month-old infant presenting with prolonged fever and pancytopenia: A case report 一名 4 个月大的婴儿感染播散性组织胞浆菌病，表现为长期发热和全血细胞减少：病例报告。

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale

Pub Date : 2025-01-04 DOI: 10.1016/j.mycmed.2025.101532

Brady Floyd , Farrah Gaston , Reem Saadoon , Nadia Shaikh , Mustafa Bakir

Background

Histoplasmosis is the most prevalent endemic mycosis in the United States, typically affecting immunocompromised individuals. Diagnosis of histoplasmosis in immunocompetent patients is rare, particularly among young infants, with only a few cases reported.

Case presentation

We present a 4-month-old female with a history of prematurity who initially presented with 11 days of fever. She visited her local emergency department, where she was diagnosed with Rhino/enterovirus bronchiolitis. Pancytopenia was noted at that time, attributed to viral bone marrow suppression. Persistent fever and pancytopenia led to her transfer to our hospital for further evaluation and treatment. On admission, she exhibited hepatosplenomegaly, pancytopenia, elevated procalcitonin, and lactate dehydrogenase levels. Additionally, T cell deficiency was observed. Initially, there was concern for hemophagocytic lymphohistiocytosis; however, bone marrow biopsy and aspirate confirmed T cell deficiency. As fever persisted on day 19, further investigations were conducted, including a positive beta-D-glucan assay. Subsequent urine and serum Histoplasma antigen tests were positive, with metagenomic sequencing confirming the diagnosis of histoplasmosis. Treatment comprised one week of amphotericin B followed by three months of oral itraconazole. Resolution of fever, pancytopenia, T cell deficiency, and hepatosplenomegaly occurred, and the patient has shown no signs of recurrence to date.

Conclusions

This case serves as a reminder to clinicians regarding the necessity of considering disseminated histoplasmosis in young infants who present with fever of unknown origin, pancytopenia, and hepatosplenomegaly, despite its rarity. Failure to do so can lead to fatal outcomes.

背景：组织胞浆菌病是美国最流行的地方性真菌病，通常影响免疫功能低下的个体。在免疫功能正常的患者中，组织浆菌病的诊断是罕见的，特别是在年幼的婴儿中，只有少数病例报道。病例介绍：我们报告一名4个月大的女性，有早产史，最初表现为11天发烧。她去了当地的急诊科，在那里她被诊断为犀牛/肠病毒细支气管炎。当时注意到全血细胞减少，归因于病毒骨髓抑制。持续发热和全血细胞减少导致她转到我们医院进一步评估和治疗。入院时，她表现出肝脾肿大、全血细胞减少、降钙素原升高和乳酸脱氢酶水平。此外，观察到T细胞缺乏。最初，人们关注的是噬血细胞性淋巴组织细胞增多症；然而，骨髓活检和抽吸证实T细胞缺乏。由于发烧持续到第19天，进行了进一步的调查，包括β - d -葡聚糖检测阳性。随后尿液和血清组织浆体抗原检测呈阳性，宏基因组测序证实了组织浆体病的诊断。治疗包括一周两性霉素B，随后三个月口服伊曲康唑。发热、全血细胞减少、T细胞缺乏和肝脾肿大消退，患者至今未出现复发迹象。结论：该病例提醒临床医生，在出现不明原因发热、全血细胞减少和肝脾肿大的婴幼儿中，有必要考虑播散性组织胞浆菌病，尽管这种情况很少见。如果不这样做，可能会导致致命的后果。

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