Pub Date : 2025-09-02DOI: 10.1016/j.mycmed.2025.101579
David Koffi , Francis K. Kouadjo , Stephane T. Koui , Kader Diarrassouba , Benjamin Djedji , Jon Salmanton-García , Valerie Ira-Bonouman , Joseph A. Djaman , Andre O. Toure
Background
The diversity of fungal species involved in medical mycology and the increasing rates of resistances make antifungal therapy increasingly challenging. A strategic approach aims to prevent the spread of resistant fungal pathogens and address the prolonged culture time required for fungal identification. The identification of microscopic fungi in biological samples has gained growing interest in molecular biology. The promising isothermal amplification technique can overcome the shortcomings of conventional methods by offering a short reaction time, as well as high specificity and sensitivity.
Objective
This study was initiated to develop a rapid method for identifying fungi from patient biological samples.
Materials.and.Methods
Ninety biological samples were collected from patients and various anatomical sites. The samples were cultured, and DNA extraction was performed on the isolates and biological products. The obtained DNA was used for amplification via RPA (Recombinase Polymerase Amplification).
Results
The results demonstrated varying sensitivity and specificity depending on the type of biological sample, with high sensitivity and specificity for mucosal samples (100 %, respectively), followed by those of invasive mycoses (80 % and 67 %, respectively), and superficial mycoses (72 % sensitivity).
Conclusion
The overall sensitivity and specificity of the RPA method across all sample types were elevated, with 92 % and 100 %, respectively.
{"title":"Performance of recombinase polymerase amplification-based assay (RPA) for rapid detection of fungal pathogens in clinical samples of patients in Abidjan, Côte d’Ivoire","authors":"David Koffi , Francis K. Kouadjo , Stephane T. Koui , Kader Diarrassouba , Benjamin Djedji , Jon Salmanton-García , Valerie Ira-Bonouman , Joseph A. Djaman , Andre O. Toure","doi":"10.1016/j.mycmed.2025.101579","DOIUrl":"10.1016/j.mycmed.2025.101579","url":null,"abstract":"<div><h3>Background</h3><div>The diversity of fungal species involved in medical mycology and the increasing rates of resistances make antifungal therapy increasingly challenging. A strategic approach aims to prevent the spread of resistant fungal pathogens and address the prolonged culture time required for fungal identification. The identification of microscopic fungi in biological samples has gained growing interest in molecular biology. The promising isothermal amplification technique can overcome the shortcomings of conventional methods by offering a short reaction time, as well as high specificity and sensitivity.</div></div><div><h3>Objective</h3><div>This study was initiated to develop a rapid method for identifying fungi from patient biological samples.</div></div><div><h3>Materials.and.Methods</h3><div>Ninety biological samples were collected from patients and various anatomical sites. The samples were cultured, and DNA extraction was performed on the isolates and biological products. The obtained DNA was used for amplification via RPA (Recombinase Polymerase Amplification).</div></div><div><h3>Results</h3><div>The results demonstrated varying sensitivity and specificity depending on the type of biological sample, with high sensitivity and specificity for mucosal samples (100 %, respectively), followed by those of invasive mycoses (80 % and 67 %, respectively), and superficial mycoses (72 % sensitivity).</div></div><div><h3>Conclusion</h3><div>The overall sensitivity and specificity of the RPA method across all sample types were elevated, with 92 % and 100 %, respectively.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 4","pages":"Article 101579"},"PeriodicalIF":1.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045652","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}
Pub Date : 2025-09-01Epub Date: 2025-07-28DOI: 10.1016/j.mycmed.2025.101571
Qinling Pan, Tengteng Xin, Jing Zhang, Li Lin, Junmin Zhang
Background: Glucose metabolism in the host is crucial during microbial infections. Here, we evaluated the effects of Fonsecaea monophora (F. monophora) wild strain and the pigment-knockout strain ΔpksA mutant on glucose metabolism and immune response of macrophages.
Methods: Glucose consumption, lactate secretion, genes related to glucose metabolism, and pro-inflammatory cytokines were measured in mouse macrophage J774A.1 cells infected with F. monophora wild strain or ΔpksA. Notably, 2-deoxy-d-glucose (2-DG) and metformin (Glucophage) were used to inhibit glucose metabolism in macrophages.
Results: The F. monophora wild strain significantly inhibited the glucose consumption level of macrophages or classically activated macrophages, and significantly inhibited the mRNA and protein levels of the tricarboxylic acid cycle gene IDH1 in macrophages. F. monophora wild strain inhibited the expression of the pro-inflammatory cytokine IL-1β in macrophages, and upregulated the expression of TNF and IL-6. Inhibition of glucose metabolism by 2-DG or metformin (Glucophage) affected the immune response of macrophages to F. monophora wild strain. The production of IL-1β in macrophages was significantly downregulated. Compared with the control group, ΔpksA did not change glucose utilization and IDH1 expression in macrophages. F. monophora wild strain inhibited IL-1β expression in macrophages, while ΔpksA promoted it.
Conclusion: Our results suggest that F. monophora wild strain reduces IL-1β expression by inhibiting the IDH1-related tricarboxylic acid cycle in macrophages. F. monophora melanin is a fungal virulence factor that inhibits glucose metabolism and regulates the immune response of macrophages.
{"title":"Metabolic immune regulation of macrophages by melanized fungus Fonsecaea monophora.","authors":"Qinling Pan, Tengteng Xin, Jing Zhang, Li Lin, Junmin Zhang","doi":"10.1016/j.mycmed.2025.101571","DOIUrl":"10.1016/j.mycmed.2025.101571","url":null,"abstract":"<p><strong>Background: </strong>Glucose metabolism in the host is crucial during microbial infections. Here, we evaluated the effects of Fonsecaea monophora (F. monophora) wild strain and the pigment-knockout strain ΔpksA mutant on glucose metabolism and immune response of macrophages.</p><p><strong>Methods: </strong>Glucose consumption, lactate secretion, genes related to glucose metabolism, and pro-inflammatory cytokines were measured in mouse macrophage J774A.1 cells infected with F. monophora wild strain or ΔpksA. Notably, 2-deoxy-d-glucose (2-DG) and metformin (Glucophage) were used to inhibit glucose metabolism in macrophages.</p><p><strong>Results: </strong>The F. monophora wild strain significantly inhibited the glucose consumption level of macrophages or classically activated macrophages, and significantly inhibited the mRNA and protein levels of the tricarboxylic acid cycle gene IDH1 in macrophages. F. monophora wild strain inhibited the expression of the pro-inflammatory cytokine IL-1β in macrophages, and upregulated the expression of TNF and IL-6. Inhibition of glucose metabolism by 2-DG or metformin (Glucophage) affected the immune response of macrophages to F. monophora wild strain. The production of IL-1β in macrophages was significantly downregulated. Compared with the control group, ΔpksA did not change glucose utilization and IDH1 expression in macrophages. F. monophora wild strain inhibited IL-1β expression in macrophages, while ΔpksA promoted it.</p><p><strong>Conclusion: </strong>Our results suggest that F. monophora wild strain reduces IL-1β expression by inhibiting the IDH1-related tricarboxylic acid cycle in macrophages. F. monophora melanin is a fungal virulence factor that inhibits glucose metabolism and regulates the immune response of macrophages.</p>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 3","pages":"101571"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812018","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}
Pub Date : 2025-08-22DOI: 10.1016/j.mycmed.2025.101572
Sirine Chtourou , Fatma Hammami , Amal Chakroun , Ons Boudawara , Tahia Boudawara , Makram Koubaa , Mounir Ben Jemaa
Background and Purpose
Cryptococcosis is a common opportunistic fungal infection in immunocompromised individuals. It is typically isolated from cerebrospinal fluid, sputum, or skin lesions. However, disseminated cryptococcosis involving the bone marrow is an extremely rare occurrence.
Case Report
This case describes a 34-year-old male patient living with HIV who developed fever, abdominal pain, and pancytopenia. Diagnostic evaluation, including bone marrow aspiration and biopsy, revealed encapsulated yeasts consistent with Cryptococcus sp. Although blood and cerebrospinal fluid cultures failed to identify fungal agents, the diagnosis of isolated bone marrow cryptococcosis was confirmed. A literature review of 21 previously reported cases (up to October 2024) was conducted, revealing a predominance of immunocompromised patients, with male patients being more frequently affected. Cytopenia was a common finding in all cases, and bone marrow biopsy was essential for diagnosis. Treatment protocols remain unstandardized.
Conclusion
Bone marrow cryptococcosis, while rare, should be considered in the differential diagnosis of pancytopenia in immunocompromised patients, particularly those with HIV.
{"title":"Bone marrow cryptococcosis in an HIV-infected patient: A case report and literature review","authors":"Sirine Chtourou , Fatma Hammami , Amal Chakroun , Ons Boudawara , Tahia Boudawara , Makram Koubaa , Mounir Ben Jemaa","doi":"10.1016/j.mycmed.2025.101572","DOIUrl":"10.1016/j.mycmed.2025.101572","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Cryptococcosis is a common opportunistic fungal infection in immunocompromised individuals. It is typically isolated from cerebrospinal fluid, sputum, or skin lesions. However, disseminated cryptococcosis involving the bone marrow is an extremely rare occurrence.</div></div><div><h3>Case Report</h3><div>This case describes a 34-year-old male patient living with HIV who developed fever, abdominal pain, and pancytopenia. Diagnostic evaluation, including bone marrow aspiration and biopsy, revealed encapsulated yeasts consistent with <em>Cryptococcus</em> sp. Although blood and cerebrospinal fluid cultures failed to identify fungal agents, the diagnosis of isolated bone marrow cryptococcosis was confirmed. A literature review of 21 previously reported cases (up to October 2024) was conducted, revealing a predominance of immunocompromised patients, with male patients being more frequently affected. Cytopenia was a common finding in all cases, and bone marrow biopsy was essential for diagnosis. Treatment protocols remain unstandardized.</div></div><div><h3>Conclusion</h3><div>Bone marrow cryptococcosis, while rare, should be considered in the differential diagnosis of pancytopenia in immunocompromised patients, particularly those with HIV.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 4","pages":"Article 101572"},"PeriodicalIF":1.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144918136","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}
Pub Date : 2025-08-19DOI: 10.1016/j.mycmed.2025.101573
Yao Xu, Jiansan He, Peng Jin, Mingming Fei, Shaohui Cheng
With opportunistic fungal pathogens increasingly recognized as a global public health threat, the population at high risk for invasive fungal infections (IFIs) has expanded beyond traditionally immunocompromised individuals—such as those with malignancies, organ transplantation, diabetes mellitus, or acquired immunodeficiency syndrome (AIDS)—to include critically ill patients in intensive care units (ICUs) receiving invasive support and immunomodulatory therapies. Invasive aspergillosis (IA) is one of the most lethal opportunistic infections in this population, characterized by insidious onset, clinical heterogeneity, and a lack of specific signs, often resulting in delayed diagnosis. Disseminated or breakthrough aspergillosis carries an exceedingly high mortality rate. We report the case of a female patient admitted to the ICU with fulminant myocarditis who required extracorporeal membrane oxygenation (ECMO), continuous renal replacement therapy (CRRT), and immunomodulation. Her hospitalization was complicated by a progressive pulmonary infection, and metagenomic next-generation sequencing (mNGS) of respiratory specimens identified Candida albicans, Aspergillus spp. and Staphylococcus hominis, prompting an adjustment in antimicrobial therapy. Subsequently, the patient developed multiple cutaneous nodules, which tissue biopsy and mNGS confirmed as invasive cutaneous aspergillosis. Despite aggressive antifungal treatment with isavuconazole and amphotericin B, her condition deteriorated rapidly, leading to disseminated cutaneous necrosis, irreversible septic shock and multiorgan failure. This case highlights the clinical importance of recognizing atypical IFI presentations. Heightened clinical suspicion for disseminated fungal disease is warranted in critically ill patients with extrapulmonary lesions. Prompt microbiological diagnosis and antifungal resistance surveillance are essential for effective antifungal therapy.
{"title":"Beyond the lungs: a case report of disseminated cutaneous aspergillosis highlighting clinical dilemmas in invasive fungal infections of critically ill patients","authors":"Yao Xu, Jiansan He, Peng Jin, Mingming Fei, Shaohui Cheng","doi":"10.1016/j.mycmed.2025.101573","DOIUrl":"10.1016/j.mycmed.2025.101573","url":null,"abstract":"<div><div>With opportunistic fungal pathogens increasingly recognized as a global public health threat, the population at high risk for invasive fungal infections (IFIs) has expanded beyond traditionally immunocompromised individuals—such as those with malignancies, organ transplantation, diabetes mellitus, or acquired immunodeficiency syndrome (AIDS)—to include critically ill patients in intensive care units (ICUs) receiving invasive support and immunomodulatory therapies. Invasive aspergillosis (IA) is one of the most lethal opportunistic infections in this population, characterized by insidious onset, clinical heterogeneity, and a lack of specific signs, often resulting in delayed diagnosis. Disseminated or breakthrough aspergillosis carries an exceedingly high mortality rate. We report the case of a female patient admitted to the ICU with fulminant myocarditis who required extracorporeal membrane oxygenation (ECMO), continuous renal replacement therapy (CRRT), and immunomodulation. Her hospitalization was complicated by a progressive pulmonary infection, and metagenomic next-generation sequencing (mNGS) of respiratory specimens identified <em>Candida albicans, Aspergillus</em> spp. and <em>Staphylococcus hominis</em>, prompting an adjustment in antimicrobial therapy. Subsequently, the patient developed multiple cutaneous nodules, which tissue biopsy and mNGS confirmed as invasive cutaneous aspergillosis. Despite aggressive antifungal treatment with isavuconazole and amphotericin B, her condition deteriorated rapidly, leading to disseminated cutaneous necrosis, irreversible septic shock and multiorgan failure. This case highlights the clinical importance of recognizing atypical IFI presentations. Heightened clinical suspicion for disseminated fungal disease is warranted in critically ill patients with extrapulmonary lesions. Prompt microbiological diagnosis and antifungal resistance surveillance are essential for effective antifungal therapy.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 4","pages":"Article 101573"},"PeriodicalIF":1.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907612","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}
Pub Date : 2025-07-03DOI: 10.1016/j.mycmed.2025.101570
Maria Noni , Anna Katelari , Konstantinos Iosifidis , Christina Kanaka-Gantenbein , Aristea Velegraki , Georgia Papaioannou , Stavros-Eleftherios Doudounakis
Lung abscess is a severe but rare complication among non-transplanted cystic fibrosis (CF) patients. <10 cases have been reported in the international literature so far and bacteria were considered the responsible pathogen. We present two cases of CF adolescent patients who developed lung abscess from A. fumigatus, critically revealed with chest Computed Tomography. In one patient, a thyroid abscess was additionally detected. Both patients presented with fever, not responding to antibiotic therapy. Microbial cultures and molecular testing aided detection of the pathogen. Both patients responded well to antifungal treatment.
{"title":"Aspergillus fumigatus lung abscess in two adolescents with cystic fibrosis","authors":"Maria Noni , Anna Katelari , Konstantinos Iosifidis , Christina Kanaka-Gantenbein , Aristea Velegraki , Georgia Papaioannou , Stavros-Eleftherios Doudounakis","doi":"10.1016/j.mycmed.2025.101570","DOIUrl":"10.1016/j.mycmed.2025.101570","url":null,"abstract":"<div><div>Lung abscess is a severe but rare complication among non-transplanted cystic fibrosis (CF) patients. <10 cases have been reported in the international literature so far and bacteria were considered the responsible pathogen. We present two cases of CF adolescent patients who developed lung abscess from <em>A. fumigatus</em>, critically revealed with chest Computed Tomography. In one patient, a thyroid abscess was additionally detected. Both patients presented with fever, not responding to antibiotic therapy. Microbial cultures and molecular testing aided detection of the pathogen. Both patients responded well to antifungal treatment.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 3","pages":"Article 101570"},"PeriodicalIF":2.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581379","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}
Pediatric isolated central nervous system (CNS) mould infections are uncommon but potentially fatal if not promptly diagnosed and treated. Such invasive lesions usually present as abscesses in parenchymal locations. Although the newer azole antifungals have shown improved outcomes, treatment data are limited in the pediatric age group, especially in young children. We report a case of a very young child with an unusual location of mould infection, in the temporal horn of the lateral ventricle, managed successfully. The 2-year-old-male child with prior COVID-19 infection and no other apparent immune dysfunction presented with features of raised intracranial pressure. CT/MRI imaging demonstrated a left temporal horn cystic lesion. Following an initial non-diagnostic aspiration of the cyst contents, the child underwent excision of the lesion. The potassium hydroxide stain of the content revealed hyaline septate hyphae, but the fungal culture was sterile. Histopathology of the specimen was highly suggestive of aspergillosis. The child was adequately treated with voriconazole, and had excellent clinical outcome at 22-month follow up. Rarely, CNS mould infection can manifest as an intraventricular space occupying lesion in children. Such a differential must be borne in mind. In our case, the infection was possibly a COVID-19 sequelae. The case also highlights the potential for successful clinical outcomes with an early and aggressive voriconazole treatment in pediatric intracranial mould infections, most likely aspergillosis.
{"title":"Intraventricular mould infection suggestive of Aspergillosis in a 2-year-old child with successful clinical outcomes","authors":"HCV Tulasi Ram , Madhivanan Karthigeyan , Aravind Sekar , Harsimran Kaur , Pravin Salunke","doi":"10.1016/j.mycmed.2025.101569","DOIUrl":"10.1016/j.mycmed.2025.101569","url":null,"abstract":"<div><div>Pediatric isolated central nervous system (CNS) mould infections are uncommon but potentially fatal if not promptly diagnosed and treated. Such invasive lesions usually present as abscesses in parenchymal locations. Although the newer azole antifungals have shown improved outcomes, treatment data are limited in the pediatric age group, especially in young children. We report a case of a very young child with an unusual location of mould infection, in the temporal horn of the lateral ventricle, managed successfully. The 2-year-old-male child with prior COVID-19 infection and no other apparent immune dysfunction presented with features of raised intracranial pressure. CT/MRI imaging demonstrated a left temporal horn cystic lesion. Following an initial non-diagnostic aspiration of the cyst contents, the child underwent excision of the lesion. The potassium hydroxide stain of the content revealed hyaline septate hyphae, but the fungal culture was sterile. Histopathology of the specimen was highly suggestive of aspergillosis. The child was adequately treated with voriconazole, and had excellent clinical outcome at 22-month follow up. Rarely, CNS mould infection can manifest as an intraventricular space occupying lesion in children. Such a differential must be borne in mind. In our case, the infection was possibly a COVID-19 sequelae. The case also highlights the potential for successful clinical outcomes with an early and aggressive voriconazole treatment in pediatric intracranial mould infections, most likely aspergillosis.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 3","pages":"Article 101569"},"PeriodicalIF":2.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614606","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}
Pub Date : 2025-06-24DOI: 10.1016/j.mycmed.2025.101560
Linling Zhang , Tingting Wu , Hongyuan Jia
Background
Invasive pulmonary aspergillosis (IPA) is a common complication in patients with hematological malignancies, and has also been reported in some solid tumors, but IPA in lung cancer patients has not been well described in recent years. This study aims to identify the risk factors for in-hospital mortality, and factors influencing antifungal efficacy in lung cancer patients with IPA.
Methods
We retrospectively collected data from all inpatients with positive aspergillus cultures or positive polymerase chain reaction(PCR) for aspergillus DeoxyriboNucleic Acid (DNA) in respiratory samples in the Third People's Hospital of Chengdu from January 2016 to December 2023. A total of 101 lung cancer patients with IPA were identified. Patients were divided into survival (n = 77) and non-survival (n = 24) groups. We analyzed their clinical characteristics, laboratory examination, risk factors for in-hospital mortality, and responses to antifungal treatment.
Results
Among 101 lung cancer patients diagnosed with IPA, The most common isolated species was Aspergillus section fumigati (61.39 %). Aspergillus culture were positive in 65 cases (64.36 %), and positive PCR were 41 cases (40.59 %). 86 patients (85.15 %) received treatment containing voriconazole or isavuconazole. The in-hospital mortality rate was 23.76 % (n = 24). Independent risk factors for in-hospital mortality included low albumin level (odds ratio [OR] 0.80, 95 % confidence interval[CI], -0.279–1.881, P = 0.0025), respiratory failure (OR 12.7, 95 % CI, 10.2–15.2,P = 0.0055), and febrile neutropenia (FN) (OR 7.33,95 % CI,5.21–9.45,P = 0.0079). In multivariate analysis of antifungal treatment response, respiratory failure was associated with lower odds of a successful response (OR 13.3, 95 %CI, 9.64–16.92, P = 0.0447), whereas treatment containing voriconazole or isavuconazole was associated with higher odds (OR 7.51, 95 % CI, 5.22–9.79, P = 0.0147).
Conclusion
Risk factors for in-hospital mortality in lung cancer patients with IPA included hypoalbuminia, FN, and respiratory failure. In antifungal treatment response, respiratory failure was associated with a lower adds of successful response, whereas treatment containing voriconazole or isavuconazole was associated with a higher odds.
{"title":"Invasive pulmonary aspergillosis in patients with lung cancer: Risk Factors for in-hospital mortality and Predictors of Clinical Outcomes","authors":"Linling Zhang , Tingting Wu , Hongyuan Jia","doi":"10.1016/j.mycmed.2025.101560","DOIUrl":"10.1016/j.mycmed.2025.101560","url":null,"abstract":"<div><h3>Background</h3><div>Invasive pulmonary aspergillosis (IPA) is a common complication in patients with hematological malignancies, and has also been reported in some solid tumors, but IPA in lung cancer patients has not been well described in recent years. This study aims to identify the risk factors for in-hospital mortality, and factors influencing antifungal efficacy in lung cancer patients with IPA.</div></div><div><h3>Methods</h3><div>We retrospectively collected data from all inpatients with positive <em>aspergillus</em> cultures or positive polymerase chain reaction(PCR) for <em>aspergillus</em> DeoxyriboNucleic Acid (DNA) in respiratory samples in the Third People's Hospital of Chengdu from January 2016 to December 2023. A total of 101 lung cancer patients with IPA were identified. Patients were divided into survival (<em>n</em> = 77) and non-survival (<em>n</em> = 24) groups. We analyzed their clinical characteristics, laboratory examination, risk factors for in-hospital mortality, and responses to antifungal treatment.</div></div><div><h3>Results</h3><div>Among 101 lung cancer patients diagnosed with IPA, The most common isolated species was <em>Aspergillus section fumigati</em> (61.39 %). <em>Aspergillus</em> culture were positive in 65 cases (64.36 %), and positive PCR were 41 cases (40.59 %). 86 patients (85.15 %) received treatment containing voriconazole or isavuconazole. The in-hospital mortality rate was 23.76 % (<em>n</em> = 24). Independent risk factors for in-hospital mortality included low albumin level (odds ratio [OR] 0.80, 95 % confidence interval[CI], -0.279–1.881, <em>P</em> = 0.0025), respiratory failure (OR 12.7, 95 % CI, 10.2–15.2,<em>P</em> = 0.0055), and febrile neutropenia (FN) (OR 7.33,95 % CI,5.21–9.45,<em>P</em> = 0.0079). In multivariate analysis of antifungal treatment response, respiratory failure was associated with lower odds of a successful response (OR 13.3, 95 %CI, 9.64–16.92, <em>P</em> = 0.0447), whereas treatment containing voriconazole or isavuconazole was associated with higher odds (OR 7.51, 95 % CI, 5.22–9.79, <em>P</em> = 0.0147).</div></div><div><h3>Conclusion</h3><div>Risk factors for in-hospital mortality in lung cancer patients with IPA included hypoalbuminia, FN, and respiratory failure. In antifungal treatment response, respiratory failure was associated with a lower adds of successful response, whereas treatment containing voriconazole or isavuconazole was associated with a higher odds.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 3","pages":"Article 101560"},"PeriodicalIF":2.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510691","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}
{"title":"Fungal infection does not impair flow cytometry signals induced by nCD64 and mCD169 biomarkers during co-infection with bacteria and viruses","authors":"Sandrine Henri, Adélaïde Chesnay, Inès Ait Belkacem, Loïc Gonzalez, Emilie Barsac, Fabrice Malergue, Guillaume Desoubeaux","doi":"10.1016/j.mycmed.2025.101562","DOIUrl":"10.1016/j.mycmed.2025.101562","url":null,"abstract":"","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 3","pages":"Article 101562"},"PeriodicalIF":2.2,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536041","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}
Pub Date : 2025-06-20DOI: 10.1016/j.mycmed.2025.101561
Harsimran Kaur , Stephen Raj , Kapil Gothwal , Deepesh Kenwar , Valliappan Muthu , Haseen Ahmad , Parikshaa Gupta , Sourav Agnihotri , Ashish Sharma , Shivaprakash M Rudramurthy
We describe a rare case of pulmonary infection by an emerging dimorphic fungus, Emergomyces pasteurianus in a 73-year-old renal transplant recipient from Northern India. The patient presented with fever and shortness of breath for ten days. The bronchoalveolar lavage revealed yeast cells and grew E. pasteurianus confirmed by sequencing internal transcribed spacer (ITS) region and large subunit of rDNA. He succumbed to the illness despite antifungal therapy comprising of liposomal amphotericin B followed by itraconazole. The case emphasizes the emergence of E. pasteurianus in renal transplant recipients.
{"title":"Fatal pulmonary mycoses by Emergomyces pasteurianus in a renal transplant recipient from India","authors":"Harsimran Kaur , Stephen Raj , Kapil Gothwal , Deepesh Kenwar , Valliappan Muthu , Haseen Ahmad , Parikshaa Gupta , Sourav Agnihotri , Ashish Sharma , Shivaprakash M Rudramurthy","doi":"10.1016/j.mycmed.2025.101561","DOIUrl":"10.1016/j.mycmed.2025.101561","url":null,"abstract":"<div><div>We describe a rare case of pulmonary infection by an emerging dimorphic fungus, <em>Emergomyces pasteurianus</em> in a 73-year-old renal transplant recipient from Northern India. The patient presented with fever and shortness of breath for ten days. The bronchoalveolar lavage revealed yeast cells and grew <em>E. pasteurianus</em> confirmed by sequencing internal transcribed spacer (ITS) region and large subunit of rDNA. He succumbed to the illness despite antifungal therapy comprising of liposomal amphotericin B followed by itraconazole. The case emphasizes the emergence of <em>E. pasteurianus</em> in renal transplant recipients.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 3","pages":"Article 101561"},"PeriodicalIF":2.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517152","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}
Phaeohyphomycosis (PHM) is a fungal infection caused by a group of dematiaceous (darkly pigmented) fungi. In this study, we describe a successfully treated case of PHM caused by Exophiala oligosperma in a 68-year-old liver transplant recipient who presented with painful erythematous subcutaneous nodules on his lower left limb. Treatment involved a combination of antifungal drugs and surgical excision. We performed review of 13 cases of PHM in liver transplant recipients reported from 2000 to 2024. Eight patients presented with skin and subcutaneous tissue involvement and limbs were the most frequently affected areas. The median time after liver transplant to the diagnosis of PHM was 6 months. Laboratory diagnosis mainly relied on histopathology. Eleven patients received systemic antifungal therapy and seven underwent surgical excision. Full recovery was observed in eleven cases. Altogether, PHM in solid organ transplant recipients is a rare infection and early diagnosis is critical for a favorable outcome.
{"title":"Phaeohyphomycosis caused by Exophiala oligosperma in liver transplant recipient: case report and literature review","authors":"Regielly Caroline Raimundo Cognialli , Bram Spruijtenburg , Leonardo Filipetto Ferrari , Denise Semchechen Hnatiuk , Alcindo Pissaia Junior , Nubia Leilane Barth Schierling , Germana Davila dos Santos , Vânia Aparecida Vicente , Eelco F.J. Meijer , Flávio Queiroz-Telles","doi":"10.1016/j.mycmed.2025.101558","DOIUrl":"10.1016/j.mycmed.2025.101558","url":null,"abstract":"<div><div>Phaeohyphomycosis (PHM) is a fungal infection caused by a group of dematiaceous (darkly pigmented) fungi. In this study, we describe a successfully treated case of PHM caused by <em>Exophiala oligosperma</em> in a 68-year-old liver transplant recipient who presented with painful erythematous subcutaneous nodules on his lower left limb. Treatment involved a combination of antifungal drugs and surgical excision. We performed review of 13 cases of PHM in liver transplant recipients reported from 2000 to 2024. Eight patients presented with skin and subcutaneous tissue involvement and limbs were the most frequently affected areas. The median time after liver transplant to the diagnosis of PHM was 6 months. Laboratory diagnosis mainly relied on histopathology. Eleven patients received systemic antifungal therapy and seven underwent surgical excision. Full recovery was observed in eleven cases. Altogether, PHM in solid organ transplant recipients is a rare infection and early diagnosis is critical for a favorable outcome.</div></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"35 3","pages":"Article 101558"},"PeriodicalIF":2.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297480","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}
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