Pub Date : 2025-02-15DOI: 10.1016/j.mmcr.2025.100698
Md. Asaduzzaman , Ranjon Kumer Roy , Suchanda Roy , Nasad Ahmed , Sazeda Akter , Monotush Ronjon Chando
This report aims to highlight rarity of disseminated histoplasmosis (DH) presenting as adrenal insufficiency and the need for considering it in the differential diagnosis, even in non-endemic areas. A case is presented of a 69-year-old male patient with a background of hypertension and diabetes mellitus, with a persistent fever, significant loss of weight, and general weakness. Imaging studies showed adrenal masses in both adrenal glands, and laboratory tests showed hyperkalemia and hyponatremia. Hormonal tests confirmed the diagnosis of adrenal insufficiency. CT-guided adrenal biopsy confirmed the diagnosis of histoplasmosis. The patient received a 14-day course of Amphotericin B, followed by oral Itraconazole and glucocorticoid substitution therapy, with improvement in adrenal function over a period of time.
{"title":"Disseminated histoplasmosis presenting as adrenal insufficiency: A case report","authors":"Md. Asaduzzaman , Ranjon Kumer Roy , Suchanda Roy , Nasad Ahmed , Sazeda Akter , Monotush Ronjon Chando","doi":"10.1016/j.mmcr.2025.100698","DOIUrl":"10.1016/j.mmcr.2025.100698","url":null,"abstract":"<div><div>This report aims to highlight rarity of disseminated histoplasmosis (DH) presenting as adrenal insufficiency and the need for considering it in the differential diagnosis, even in non-endemic areas. A case is presented of a 69-year-old male patient with a background of hypertension and diabetes mellitus, with a persistent fever, significant loss of weight, and general weakness. Imaging studies showed adrenal masses in both adrenal glands, and laboratory tests showed hyperkalemia and hyponatremia. Hormonal tests confirmed the diagnosis of adrenal insufficiency. CT-guided adrenal biopsy confirmed the diagnosis of histoplasmosis. The patient received a 14-day course of Amphotericin B, followed by oral Itraconazole and glucocorticoid substitution therapy, with improvement in adrenal function over a period of time.</div></div>","PeriodicalId":51724,"journal":{"name":"Medical Mycology Case Reports","volume":"47 ","pages":"Article 100698"},"PeriodicalIF":1.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fungal peritonitis in peritoneal dialysis (PD) presents significant challenges. We report the second Quambalaria cyanescens-related PD peritonitis in a 53-year-old male. Negative bacterial cultures and a positive galactomannan (GM) index in both PD effluent (PDE) (0.65) and serum (0.98) prompted early PD catheter removal on day 5. Molecular sequencing confirmed Q. cyanescens, with antifungal susceptibility testing revealing resistance to azoles and echinocandins but susceptibility to amphotericin B and isavuconazonium. Treatment with amphotericin B and voriconazole resolved symptoms, with no relapses during a two-year follow-up. This case highlights GM testing's critical role in guiding catheter removal and adherence to the 2022 ISPD Peritonitis Guidelines, ensuring favorable outcomes for rare fungal PD infections.
{"title":"Timely diagnosis and management of Quambalaria cyanescens-induced peritoneal dialysis peritonitis: A rare case highlighting the role of galactomannan testing","authors":"Baramett Somtha , Kanjana Tianprasertkij , Supattra Promngam , Thunvarat Saejew , Talerngsak Kanjanabuch","doi":"10.1016/j.mmcr.2025.100697","DOIUrl":"10.1016/j.mmcr.2025.100697","url":null,"abstract":"<div><div>Fungal peritonitis in peritoneal dialysis (PD) presents significant challenges. We report the second <em>Quambalaria cyanescens</em>-related PD peritonitis in a 53-year-old male. Negative bacterial cultures and a positive galactomannan (GM) index in both PD effluent (PDE) (0.65) and serum (0.98) prompted early PD catheter removal on day 5. Molecular sequencing confirmed <em>Q. cyanescens</em>, with antifungal susceptibility testing revealing resistance to azoles and echinocandins but susceptibility to amphotericin B and isavuconazonium. Treatment with amphotericin B and voriconazole resolved symptoms, with no relapses during a two-year follow-up. This case highlights GM testing's critical role in guiding catheter removal and adherence to the 2022 ISPD Peritonitis Guidelines, ensuring favorable outcomes for rare fungal PD infections.</div></div>","PeriodicalId":51724,"journal":{"name":"Medical Mycology Case Reports","volume":"47 ","pages":"Article 100697"},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This report documents the first human case of Eidernor doerrieniae colonization in a peritoneal dialysis catheter, identified through DNA sequencing after a 52-year-old man observed brownish particles within his catheter. Despite the absence of peritonitis symptoms, prompt catheter removal and antifungal therapy successfully resolved the infection. Fungal cultures revealed cerebriform (brain-like) colonies, confirmed as E. doerrieniae using multi-targeted molecular diagnostics. A wet contamination event three weeks earlier was identified as the likely source. This case underscores the importance of recognizing intraluminal particles as an indicator of fungal colonization and highlights the critical role of timely intervention and advanced diagnostics in preventing fungal peritonitis.
{"title":"First human case of Eidernor doerrieniae colonization in a peritoneal dialysis catheter: A warning from silent contamination","authors":"Phichit Songviriyavithaya , Aschariya Wipattanakitcharoen , Niparat Pikul , Dhammika Leshan Wannigama , Talerngsak Kanjanabuch","doi":"10.1016/j.mmcr.2025.100696","DOIUrl":"10.1016/j.mmcr.2025.100696","url":null,"abstract":"<div><div>This report documents the first human case of <em>Eidernor doerrieniae</em> colonization in a peritoneal dialysis catheter, identified through DNA sequencing after a 52-year-old man observed brownish particles within his catheter. Despite the absence of peritonitis symptoms, prompt catheter removal and antifungal therapy successfully resolved the infection. Fungal cultures revealed cerebriform (brain-like) colonies, confirmed as <em>E. doerrieniae</em> using multi-targeted molecular diagnostics. A wet contamination event three weeks earlier was identified as the likely source. This case underscores the importance of recognizing intraluminal particles as an indicator of fungal colonization and highlights the critical role of timely intervention and advanced diagnostics in preventing fungal peritonitis.</div></div>","PeriodicalId":51724,"journal":{"name":"Medical Mycology Case Reports","volume":"47 ","pages":"Article 100696"},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-22DOI: 10.1016/j.mmcr.2025.100694
Shuyan Quan , Hong Li , Kailing Li , Xuan Wang , Yang Xu , Peng Gu
Hormonal fluctuations during pregnancy increase susceptibility to Candida infections, typically presenting as vulvovaginal candidiasis, but rarely as oropharyngeal candidiasis. We report a rare case of a woman being pregnant for 27 + 1 weeks with twins with oropharyngeal candidiasis, likely attributed to nutritional anemia and adverse reactions of amoxicillin. Following a thorough literature review and evaluation of medication safety during pregnancy regarding route, dosage, and gestational stage, we treated the patient with fluconazole and piperacillin-tazobactam. The patient fully recovered and successfully delivered two infants via cesarean section at term, with no adverse reactions noted during a six-month follow-up.
{"title":"Severe oropharyngeal candidiasis in an anemic pregnant woman: A case report","authors":"Shuyan Quan , Hong Li , Kailing Li , Xuan Wang , Yang Xu , Peng Gu","doi":"10.1016/j.mmcr.2025.100694","DOIUrl":"10.1016/j.mmcr.2025.100694","url":null,"abstract":"<div><div>Hormonal fluctuations during pregnancy increase susceptibility to <em>Candida</em> infections, typically presenting as vulvovaginal candidiasis, but rarely as oropharyngeal candidiasis. We report a rare case of a woman being pregnant for 27 + 1 weeks with twins with oropharyngeal candidiasis, likely attributed to nutritional anemia and adverse reactions of amoxicillin. Following a thorough literature review and evaluation of medication safety during pregnancy regarding route, dosage, and gestational stage, we treated the patient with fluconazole and piperacillin-tazobactam. The patient fully recovered and successfully delivered two infants via cesarean section at term, with no adverse reactions noted during a six-month follow-up.</div></div>","PeriodicalId":51724,"journal":{"name":"Medical Mycology Case Reports","volume":"47 ","pages":"Article 100694"},"PeriodicalIF":1.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-20DOI: 10.1016/j.mmcr.2025.100695
Thi Minh Chau Ngo , Dong Duong Ton That , Phuong Anh Ton Nu , Le Chi Cao , My Nguyen Thi Tra , Thi Quynh Trang Tran
Onychomycosis is an uncommon disease in pediatric patients with dermatophytes and Candida spp. being the main causative agents. Kodamaea ohmeri has recently emerged as a human pathogen, including an onychomycosis causative agent. Here, we report the first case of childhood onychomycosis caused by K. ohmeri in Vietnam, presenting clinically as a white superficial onychomycosis. Fungal identification was confirmed by sequencing of the ITS1-2 region. Antifungal susceptibility testing revealed low minimum inhibitory concentrations for all tested agents, except fluconazole and caspofungin. The patient was treated with 2 % ketoconazole cream one month, resulting in complete resolution of the nail damage with no relapse observed after six months.
{"title":"A case report of childhood onychomycosis caused by the rare yeast Kodamaea ohmeri","authors":"Thi Minh Chau Ngo , Dong Duong Ton That , Phuong Anh Ton Nu , Le Chi Cao , My Nguyen Thi Tra , Thi Quynh Trang Tran","doi":"10.1016/j.mmcr.2025.100695","DOIUrl":"10.1016/j.mmcr.2025.100695","url":null,"abstract":"<div><div>Onychomycosis is an uncommon disease in pediatric patients with dermatophytes and <em>Candida</em> spp. being the main causative agents. <em>Kodamaea ohmeri</em> has recently emerged as a human pathogen, including an onychomycosis causative agent. Here, we report the first case of childhood onychomycosis caused by <em>K. ohmeri</em> in Vietnam, presenting clinically as a white superficial onychomycosis. Fungal identification was confirmed by sequencing of the ITS1-2 region. Antifungal susceptibility testing revealed low minimum inhibitory concentrations for all tested agents, except fluconazole and caspofungin. The patient was treated with 2 % ketoconazole cream one month, resulting in complete resolution of the nail damage with no relapse observed after six months.</div></div>","PeriodicalId":51724,"journal":{"name":"Medical Mycology Case Reports","volume":"47 ","pages":"Article 100695"},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-20DOI: 10.1016/j.mmcr.2025.100693
Alex Rivero , Megan Shaughnessy , Jessica Oswald , Nicholas Goodhope , Margret Oethinger
Mucormycosis is an invasive infection caused by fungi of the order Mucorales, typically affecting immunocompromised individuals, and rarely involving the gastrointestinal tract. We report two cases of gastrointestinal mucormycosis by Mucor indicus: a 77-year-old woman with a gastric ulcer and a 25-year-old man with liver lesions. Both were treated with surgery and liposomal amphotericin B; only one survived. Recognizing gastrointestinal mucormycosis in the correct clinical context is essential and requires timely surgical and antifungal treatment.
2012 Elsevier Ltd. All rights reserved.
{"title":"Gastrointestinal mucormycosis by Mucor indicus: A report of two cases","authors":"Alex Rivero , Megan Shaughnessy , Jessica Oswald , Nicholas Goodhope , Margret Oethinger","doi":"10.1016/j.mmcr.2025.100693","DOIUrl":"10.1016/j.mmcr.2025.100693","url":null,"abstract":"<div><div>Mucormycosis is an invasive infection caused by fungi of the order Mucorales, typically affecting immunocompromised individuals, and rarely involving the gastrointestinal tract. We report two cases of gastrointestinal mucormycosis by <em>Mucor indicus:</em> a 77-year-old woman with a gastric ulcer and a 25-year-old man with liver lesions. Both were treated with surgery and liposomal amphotericin B; only one survived. Recognizing gastrointestinal mucormycosis in the correct clinical context is essential and requires timely surgical and antifungal treatment.</div><div>2012 Elsevier Ltd. All rights reserved.</div></div>","PeriodicalId":51724,"journal":{"name":"Medical Mycology Case Reports","volume":"47 ","pages":"Article 100693"},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-11DOI: 10.1016/j.mmcr.2025.100692
J.D. Ringhofer , E.M. HIrsch , S.R. Michalak , N. Wiederhold , C. Cañete-Gibas , J.D. Dear
We report disseminated mycosis in a Belgian Malinois caused by Scytalidium philadelphianum. The dog presented for progressive hindlimb weakness after diagnosis of suspected bacterial discospondylitis. Magnetic resonance imaging combined with radiographs revealed multifocal discospondylitis, osteomyelitis, and spondylitis with epidural empyema. Scytalidium philadelphianum was identified on culture and DNA sequencing of urine and fine needle aspirates of affected disc spaces. Aggressive therapy including amphotericin B liposomal complex, micafungin, and azoles were initiated, but the dog was euthanized seven months later due to progressive neurologic disease. This is the first report of disseminated disease by Scytalidium philadelphianum in veterinary medicine.
{"title":"Disseminated Scytalidium philadelphianum infection in a Belgian Malinois","authors":"J.D. Ringhofer , E.M. HIrsch , S.R. Michalak , N. Wiederhold , C. Cañete-Gibas , J.D. Dear","doi":"10.1016/j.mmcr.2025.100692","DOIUrl":"10.1016/j.mmcr.2025.100692","url":null,"abstract":"<div><div>We report disseminated mycosis in a Belgian Malinois caused by <em>Scytalidium philadelphianum</em>. The dog presented for progressive hindlimb weakness after diagnosis of suspected bacterial discospondylitis. Magnetic resonance imaging combined with radiographs revealed multifocal discospondylitis, osteomyelitis, and spondylitis with epidural empyema. <em>Scytalidium philadelphianum</em> was identified on culture and DNA sequencing of urine and fine needle aspirates of affected disc spaces. Aggressive therapy including amphotericin B liposomal complex, micafungin, and azoles were initiated, but the dog was euthanized seven months later due to progressive neurologic disease. This is the first report of disseminated disease by <em>Scytalidium philadelphianum</em> in veterinary medicine.</div></div>","PeriodicalId":51724,"journal":{"name":"Medical Mycology Case Reports","volume":"47 ","pages":"Article 100692"},"PeriodicalIF":1.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-25DOI: 10.1016/j.mmcr.2024.100691
Makoto Ishiai, Hiroshi Tanabe
We report a case of kerion celsi caused by Trichophyton tonsurans in a teenage male judo athlete, presenting with a lesion in the occipital region. Following the initiation of systemic antifungal therapy, the patient developed a dermatophytid reaction, necessitating differentiation from a drug eruption. Direct microscopy of the affected area confirmed the presence of fungal elements, and histopathological examination revealed endothrix invasion, supporting the continuation of treatment. A drug-induced lymphocyte stimulation test for terbinafine, conducted post-treatment, was negative. This case highlights the importance of distinguishing dermatophytid reactions from drug eruptions to ensure uninterrupted antifungal therapy.
{"title":"A case of kerion celsi caused by Trichophyton tonsurans with dermatophytid reaction mimicking a drug eruption and endothrix infection confirmed in pathological tissue","authors":"Makoto Ishiai, Hiroshi Tanabe","doi":"10.1016/j.mmcr.2024.100691","DOIUrl":"10.1016/j.mmcr.2024.100691","url":null,"abstract":"<div><div>We report a case of kerion celsi caused by <em>Trichophyton tonsurans</em> in a teenage male judo athlete, presenting with a lesion in the occipital region. Following the initiation of systemic antifungal therapy, the patient developed a dermatophytid reaction, necessitating differentiation from a drug eruption. Direct microscopy of the affected area confirmed the presence of fungal elements, and histopathological examination revealed endothrix invasion, supporting the continuation of treatment. A drug-induced lymphocyte stimulation test for terbinafine, conducted post-treatment, was negative. This case highlights the importance of distinguishing dermatophytid reactions from drug eruptions to ensure uninterrupted antifungal therapy.</div></div>","PeriodicalId":51724,"journal":{"name":"Medical Mycology Case Reports","volume":"47 ","pages":"Article 100691"},"PeriodicalIF":1.6,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-12DOI: 10.1016/j.mmcr.2024.100690
Rik van den Biggelaar , Tristan Couwenbergh , Alexander C.A.P. Leenders , C.A. van der Sloot , Henrich van der Lee , Jochem B. Buil
A 49-year old female, known to have had an asymptomatic pulmonary cavity since 2015, presented in 2023 with hemoptysis. Radiology showed a mass suspected to be an aspergilloma. Due to persistent hemoptysis, lobectomy was performed. Pathological examination revealed fungal hyphae, and the cultured fungus was identified as a Coccidioides species by LSU sequencing. Microscopy, culture, and ITS sequencing at the national reference center confirmed the identification of Coccidioides posadasii. The patient's last visit to an endemic region was 13 years before the symptomatic disease.
{"title":"Pulmonary coccidioidomycosis presenting as a fungal ball mimicking aspergilloma","authors":"Rik van den Biggelaar , Tristan Couwenbergh , Alexander C.A.P. Leenders , C.A. van der Sloot , Henrich van der Lee , Jochem B. Buil","doi":"10.1016/j.mmcr.2024.100690","DOIUrl":"10.1016/j.mmcr.2024.100690","url":null,"abstract":"<div><div>A 49-year old female, known to have had an asymptomatic pulmonary cavity since 2015, presented in 2023 with hemoptysis. Radiology showed a mass suspected to be an aspergilloma. Due to persistent hemoptysis, lobectomy was performed. Pathological examination revealed fungal hyphae, and the cultured fungus was identified as a Coccidioides species by LSU sequencing. Microscopy, culture, and ITS sequencing at the national reference center confirmed the identification of Coccidioides posadasii. The patient's last visit to an endemic region was 13 years before the symptomatic disease.</div></div>","PeriodicalId":51724,"journal":{"name":"Medical Mycology Case Reports","volume":"47 ","pages":"Article 100690"},"PeriodicalIF":1.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 42-year-old woman was referred to an emergency department. She had an unresponsive corneal ulcer that was initially diagnosed as Herpes simplex virus keratitis. Later, the microbiological studies revealed fungal keratitis. Although the patient was given topical antifungal medication, the clinical presentation did not support improvement. Despite using antifungal medication, the infiltration continued to progress, and the patient underwent therapeutic penetrating keratoplasty (T-PKP). Corneal tissue was collected and sent for histopathologic and molecular examination. The results revealed the presence of both Acanthamoeba T4 subgroup and Fusarium sp. This case emphasizes the importance of considering Acanthamoeba infection in progressive and non-responsive infectious keratitis, especially fungal specimens. Polymerase chain reaction (PCR) is an appropriate laboratory molecular diagnostic test for accurate diagnosis of Acanthamoeba keratitis.
{"title":"Fungal keratitis complicating the diagnosis of Acanthamoeba keratitis","authors":"Mehrnaz Atighehchian , Alireza Latifi , Zohreh Nozarian , Fahimeh Asadi Amoli , Mehran Zarei-Ghanavati","doi":"10.1016/j.mmcr.2024.100687","DOIUrl":"10.1016/j.mmcr.2024.100687","url":null,"abstract":"<div><div>A 42-year-old woman was referred to an emergency department. She had an unresponsive corneal ulcer that was initially diagnosed as <em>Herpes simplex</em> virus keratitis. Later, the microbiological studies revealed fungal keratitis. Although the patient was given topical antifungal medication, the clinical presentation did not support improvement. Despite using antifungal medication, the infiltration continued to progress, and the patient underwent therapeutic penetrating keratoplasty (T-PKP). Corneal tissue was collected and sent for histopathologic and molecular examination. The results revealed the presence of both <em>Acanthamoeba</em> T4 subgroup and <em>Fusarium</em> sp. This case emphasizes the importance of considering <em>Acanthamoeba</em> infection in progressive and non-responsive infectious keratitis, especially fungal specimens. Polymerase chain reaction (PCR) is an appropriate laboratory molecular diagnostic test for accurate diagnosis <em>of Acanthamoeba</em> keratitis.</div></div>","PeriodicalId":51724,"journal":{"name":"Medical Mycology Case Reports","volume":"47 ","pages":"Article 100687"},"PeriodicalIF":1.6,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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