WorldWideScience

Sample records for blastomycosis

  1. Cutaneous blastomycosis in New Brunswick: case report

    OpenAIRE

    Ross, John J.; Keeling, Douglas N.

    2000-01-01

    Blastomycosis is a fungal infection of immunocompetent hosts. We present a case of cutaneous blastomycosis acquired in New Brunswick, which provides evidence that this disease is endemic in Atlantic Canada. This case also demonstrates that the diagnosis of blastomycosis may be elusive. Perseverance, a high index of clinical suspicion and close cooperation with the microbiology laboratory may be required to diagnose this uncommon condition.

  2. Cutaneous Blastomycosis Masquerading as Pyoderma Gangrenosum

    OpenAIRE

    Azar, Marwan M; Relich, Ryan F.; Schmitt, Bryan H.; Spech, Robert W.; Hage, Chadi A.

    2014-01-01

    Cutaneous blastomycosis (CB) is associated with a variety of skin manifestations. Among other entities, CB may be mistaken for pyoderma gangrenosum due to overlap of findings on histopathologic examination. We report a case of CB, initially diagnosed as pyoderma gangrenosum and treated with steroids, leading to disseminated blastomycosis and acute respiratory distress syndrome (ARDS).

  3. Computed Tomographic Scan Evaluation of Pulmonary Blastomycosis

    Directory of Open Access Journals (Sweden)

    Suzanne Ronald

    2009-01-01

    Full Text Available BACKGROUND: Blastomycosis is an uncommon granulomatous pulmonary and extrapulmonary infectious disease caused by the thermally dimorphic fungus Blastomyces dermatitidis. Diagnosis may be delayed or difficult because of varied presentation. The characteristics of blastomycosis on computed tomographic (CT scan of the chest are not well characterized.

  4. Systemic blastomycosis in a horse.

    Science.gov (United States)

    Wilson, Julia H; Olson, Erik J; Haugen, Edward W; Hunt, Luanne M; Johnson, Jennifer L; Hayden, David W

    2006-11-01

    Progressive multisystemic disease caused by Blastomyces dermatitidis was diagnosed in a 17-year-old Quarter horse broodmare. The mare had been treated unsuccessfully with antibiotics for mastitis 3 months postpartum. The disease progressed to exudative cutaneous lesions affecting the ventrum, pectoral region, and limbs accompanied by weight loss across several months. Yeast bodies were observed in swabs of the cutaneous exudate, suggesting a clinical diagnosis of blastomycosis. Following referral, pleural effusion, cavitated lung lesions, and hyperproteinemia were identified, and the mare was euthanized because of poor prognosis. Necropsy revealed extensive pyogranulomas in the mammary gland, skin, subcutaneous tissues, and lungs, accompanied by thrombi in major blood vessels of the lungs and hind limbs. Histologically, pyogranulomatous inflammation was evident in many tissues, and fungal organisms were seen in sections of mammary gland, skin, subcutis, pericardium, and lung. Blastomyces dermatitidis was cultured from mammary tissue, lungs, lymph node, and an inguinal abscess. Although blastomycosis is endemic in the area of origin of the mare in northwestern Wisconsin, the disease is extremely rare in horses and hence easily misdiagnosed. Unique features of this case included the extent of mammary gland involvement and the presence of thrombi in multiple sites. PMID:17121096

  5. Blastomycosis in Northwestern Ontario, 2004 to 2014

    Directory of Open Access Journals (Sweden)

    Daniel Dalcin

    2015-01-01

    Full Text Available Blastomycosis is an invasive fungal disease caused by Blastomyces dermatitidis and the recently discovered Blastomyces gilchristii. The medical charts of 64 patients with confirmed cases of blastomycosis in northwestern Ontario during a 10-year period (2004 to 2014 were retrospectively reviewed. The number of patients diagnosed with blastomycosis in Ontario was observed to have increased substantially compared with before 1990, when blastomycosis was removed from the list of reportable diseases. Aboriginals were observed to be disproportionately represented in the patient population. Of the patients whose smoking status was known, 71.4% had a history of smoking. 59.4% of patients had underlying comorbidities and a higher comorbidity rate was observed among Aboriginal patients. The case-fatality rate from direct complications of blastomycosis disease was calculated to be 20.3%; this case-fatality rate is the highest ever to be reported in Canada and more than double that of previously published Canadian studies. The clinical characteristics of 64 patients diagnosed with blastomycosis are summarized.

  6. Blastomycosis

    Science.gov (United States)

    ... Blastomyces dermatidis is found in central and southeastern United States (the darkened area on the map, right) and Map source: www.familyvet.com/Dogs/Fungi.html parts of Canada. There has been an ...

  7. Blastomycosis

    Science.gov (United States)

    ... Candidiasis Oropharyngeal / Esophageal Candidiasis Genital / vulvovaginal candidiasis Invasive candidiasis Definition Symptoms Risk & Prevention Sources Diagnosis Treatment Statistics Healthcare Professionals ...

  8. Thoracic and abdominal blastomycosis in a horse.

    Science.gov (United States)

    Toribio, R E; Kohn, C W; Lawrence, A E; Hardy, J; Hutt, J A

    1999-05-01

    A 5-year-old Quarter Horse mare was examined because of lethargy, fever, and weight loss of 1 month's duration. Thoracic auscultation revealed decreased lung sounds cranioventrally. Thoracic ultrasonography revealed bilateral anechoic areas with hyperechoic strands, consistent with pleural effusion and fibrin tags. A large amount of free fluid was evident during abdominal ultrasonography. Abnormalities included anemia, hyperproteinemia, hyperglobulinemia, hyperfibrinogenemia, and hypoalbuminemia. Thoracic radiography revealed alveolar infiltrates in the cranial and caudoventral lung fields. A cavitary mass, consistent with an abscess, could be seen caudodorsal to the crura of the diaphragm. Ultrasonographic evaluation of this area revealed a hypoechoic mass with septations. Bilateral thoracocentesis was performed. Bacterial culture of the pleural fluid did not yield growth, but Blastomyces dermatitidis was isolated from pleural fluid, abdominal fluid, and an aspirate of the abscess. The mare was euthanatized, and a diagnosis of thoracic and abdominal blastomycosis was confirmed at necropsy. PMID:10319179

  9. Outcomes of persons with blastomycosis involving the central nervous system.

    Science.gov (United States)

    Bush, Jonathan W; Wuerz, Terry; Embil, John M; Del Bigio, Marc R; McDonald, Patrick J; Krawitz, Sherry

    2013-06-01

    Blastomyces dermatitidis is a dimorphic fungus which is potentially life-threatening if central nervous system (CNS) dissemination occurs. Sixteen patients with proven or probable CNS blastomycosis are presented. Median duration of symptoms was 90 days; headache and focal neurologic deficit were the most common presenting symptoms. Magnetic resonance imaging (MRI) consistently demonstrated an abnormality, compared to 58% of computed tomography scans. Tissue culture yielded the pathogen in 71% of histology-confirmed cases. All patients who completed treatment of an amphotericin B formulation and extended azole-based therapy did not relapse. Initial nonspecific symptoms lead to delayed diagnosis of CNS blastomycosis. A high index of suspicion is necessary if there is history of contact with an area where B. dermatitidis is endemic. Diagnostic tests should include MRI followed by biopsy for tissue culture and pathology. Optimal treatment utilizes a lipid-based amphotericin B preparation with an extended course of voriconazole. PMID:23566338

  10. Magnetic resonance spectroscopy imaging characteristics of cerebral Blastomycosis

    Directory of Open Access Journals (Sweden)

    Jay A Vachhani

    2014-01-01

    Full Text Available Background: Blastomycosis is a dimorphic fungus that is endemic to the midwest and southwestern United States. Involvement of the central nervous system (CNS is thought to only represent 5-10% of cases of disseminated Blastomycosis. Case Description: A 54-year-old Caucasian female presented to the Neurosurgery service with a 1-day history of progressive right sided hemiparesis. Magnetic resonance imaging (MRI demonstrated a 2 × 4 cm heterogeneous intracranial mass lesion involving the left motor cortex and extending into the ipsilateral parietal lobe. Single-voxel magnetic resonance spectroscopy (MRS over the enhancing area demonstrated diminished N-acetyl aspartate (NAA to creatine ratio (1.10, normal choline to NAA ratio (0.82, normal choline to creatine ratio (0.9, and a diminished myoinositol to creatine ratio (0.39. There appeared to be peaks between 3.6 and 3.8 ppm over the enhancing area that were not present in the contralateral normal brain and thought to represent a "trehalose" peak. Due to worsening symptoms and uncertain preoperative diagnosis, the patient underwent a left fronto-parietal craniotomy for open surgical biopsy with possible resection approximately one month after presentation. Pathological analysis confirmed the diagnosis of Blastomycosis. Conclusion: We present the second documented case of intracranial Blastomycosis with MRS imaging. There appears to be a characteristic peak between 3.6 and 3.8 ppm that is thought to represent a "trehalose" peak. This peak is rather specific to fungi and can be helpful in differentiating fungal abscesses from pyogenic abscesses and malignant neoplasms.

  11. The endemic mimic: blastomycosis an illness often misdiagnosed.

    Science.gov (United States)

    Bradsher, Robert W

    2014-01-01

    One of the endemic fungi, Blastomyces dermatitidis, can cause epidemics of infection with multiple persons involved in a point source outbreak but more commonly causes sporadic cases of infection within the areas of endemicity. Blastomycosis can present as an acute pneumonia which is often misdiagnosed as acute pneumococcal pneumonia or the infection may present as a chronic pneumonia along with weight loss, night sweats, hemoptysis, and a lung mass suggesting tuberculosis or carcinoma of the lung. Extrapulmonary infection with B. dermatitidis is protean with many different manifestations. Most commonly, skin or subcutaneous lesions are found with either a verrucous or warty appearance or in an ulcerative form. Cases have been misidentified as keratoacanthoma, pyoderma gangrenosum, carcinoma, or as Weber-Christian panniculitis if there are nodular subcutaneous lesions. Essentially any site or organ can have lesions of disseminated blastomycosis. In our series, cases of laryngeal carcinoma, adrenal insufficiency, thyroid nodules, granulomatous hypercalcemia, abnormal mammograms thought to represent breast carcinoma, otitis media with cranial extension, immune thrombocytopenic purpura, and hemolytic anemia of unknown cause have been misdiagnosed and blastomycosis subsequently identified as the cause. This infection causes manifestations which mimic many other more commonly diagnosed conditions and must always be considered by clinicians practicing in the endemic region. PMID:25125734

  12. Pulmonary Blastomycosis in Vilas County, Wisconsin: Weather, Exposures and Symptoms

    Directory of Open Access Journals (Sweden)

    Dennis J. Baumgardner

    2015-01-01

    Full Text Available Purpose: Blastomycosis is a serious fungal infection contracted by inhalation of Blastomyces spores from the environment. Case occurrence in dogs in Vilas County, Wisconsin, has been associated with antecedent weather. We aimed to explore the effects of weather on the occurrence of human pulmonary blastomycosis in this area, and update exposure factors and symptoms since last published reports. Methods: Mandatory case reports were reviewed. Chi-square test was used for categorical data of exposures, comparing 1979–1996 (n=101 versus 1997–June 2013 (n=95. Linear regression was used to model local weather data (available 1990–2013; n=126; Southern Oscillation Index (SOI, North Atlantic Oscillation Index (NAOI, and Wisconsin River water discharge (WRD from the adjacent county (all available for 1984–2013; n=174; and case counts of known onset by warm (April–September and cold (October–March 6-month periods. Results: Distribution of pulmonary blastomycosis cases did not vary by season. Environmental exposures for the 1997–June 2013 group (mean age 45, 59% male were: residence(76%, excavation (42% and gardening (31%, all similar to the 1979–1996 group. Fishing (23% vs. 37%; P=0.09 and hunting (15% vs. 26%; P=0.13 exposures were less common in 1997–June 2013, but not significantly different. Overall, 69% of cases recalled some prior soil-disturbing activities. Considering the 6-month warm/cold periods, 19% of variation is explained by a direct relationship with total precipitation from two periods prior (P=0.005. There was no association of case occurrence with SOI, NAOI or WRD. Estimated annual incidence of blastomycosis for 1997–June 2013 was 27/100,000 compared with 44/100,000 for 1984–1996. Several symptoms were significantly less frequent in 2002–June 2013 compared to earlier years. Conclusions: As with dogs, human pulmonary blastomycosis occurrence is partially determined by antecedent precipitation. It is unclear if

  13. Probable Pulmonary Blastomycosis in a Wild Coyote (Canis latrans

    Directory of Open Access Journals (Sweden)

    Luis E. Rodríguez-Tovar

    2015-01-01

    Full Text Available A female coyote (Canis latrans was fatally injured by a vehicle on a road in San Luis Potosi, Mexico. Because of deteriorating clinical signs, the animal was euthanized. Postmortem examination of the lungs showed numerous small multifocal white nodules (0.5–1 cm diameter disseminated throughout. Histopathologic examination revealed multifocal coalescing granulomas with abundant macrophages, numerous neutrophils, fibroblasts, plasma cells, and lymphocytes. Abundant intracellular and extracellular thick-walled, refractile, spherical yeasts (10–15 μm were observed within the granulomas. The yeasts were intensely PAS-positive, with granular protoplasm. Broad-based single budding yeasts were occasionally present. Based on the microscopic findings of the pulmonary lesions and the morphological features of the organism, a diagnosis of chronic pyogranulomatous pneumonia caused by Blastomyces dermatitidis was made. To our knowledge, the case described herein is the first report of pulmonary blastomycosis in a wild coyote.

  14. Spatial epidemiology of blastomycosis hospitalizations: detecting clusters and identifying environmental risk factors.

    Science.gov (United States)

    Seitz, Amy E; Adjemian, Jennifer; Steiner, Claudia A; Prevots, D Rebecca

    2015-06-01

    Blastomycosis is a disease caused by endemic fungi that ranges from severe pulmonary or disseminated to mild or asymptomatic. Environmental factors associated with it are not well described throughout the endemic area. We used the intramural State Inpatient Database from the Agency for Healthcare Research and Quality and ArcMap GIS to identify geographic high-risk clusters of blastomycosis hospitalizations in 13 states in the US endemic regions (AR, IA, IL, IN, KY, LA, MI, MN, MO, MS, OH, TN, and WI). We then used logistic regression to identify risk factors associated with these high-risk clusters. We describe six clusters of counties in which there was an elevated incidence of blastomycosis hospitalizations. We identified maximum mean annual temperature, percentage of persons aged ≥65 years, and mercury and copper soil content as being associated with high-risk clusters. Specifically, the odds of a county being part of a high-risk cluster was associated with increasing percentage of population over age 65, decreasing maximum temperature, increasing mercury, and decreasing copper soil content. Healthcare providers should be aware of these high-risk areas so that blastomycosis can be included, as appropriate, in a differential diagnosis for patients currently or previously residing in these areas. PMID:25908653

  15. Blastomycosis Mortality Rates, United States, 1990–2010

    Centers for Disease Control (CDC) Podcasts

    2015-01-05

    Diana Khuu discusses Blastomycosis Mortality Rates, United States, 1990–2010.  Created: 1/5/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/7/2015.

  16. Multimodality imaging in cranial blastomycosis, a great mimicker: Case-based illustration with review of clinical and imaging findings

    Directory of Open Access Journals (Sweden)

    Puneet S Kochar

    2016-01-01

    Full Text Available We describe the clinical, laboratory, and imaging data of three patients who are proven cases of blastomycosis with cranial involvement. In this review, we discuss the imaging features of cranial blastomycosis with relevant clinical case examples including computed tomography (CT, magnetic resonance imaging (MRI, and advanced MR imaging techniques like magnetic resonance spectroscopy (MRS and MR perfusion. Literature is reviewed for modern-day diagnosis and treatment of this fatal intracranial infection, if not diagnosed promptly and managed effectively.

  17. Investigation of anti-WI-1 adhesin antibody-mediated protection in experimental pulmonary blastomycosis.

    Science.gov (United States)

    Wüthrich, M; Klein, B S

    2000-05-01

    Infection with Blastomyces dermatitidis elicits strong antibody responses to the surface adhesin WI-1. The antibodies are directed chiefly against the adhesive domain, a 25-amino-acid repeat. Tandem-repeat-specific monoclonal antibodies (mAbs) were studied for their opsonic activity in vitro and their capacity to adoptively transfer protection in murine experimental blastomycosis. mAbs to WI-1 enhanced binding and entry of B. dermatitidis yeasts into J774. 16 cells but did not enhance killing or growth inhibition of the yeast. Passive transfer of 8 mAbs to WI-1 into 3 different inbred strains of mice also did not improve the course of experimental infection and sometimes worsened it. mu-deficient mice were more resistant to experimental blastomycosis than were intact littermates, and passive transfer of the mAbs into these mice did not protect them against experimental infection. Thus, antibody to WI-1 does not appear to improve the outcome of murine blastomycosis and may enhance the infection. PMID:10823774

  18. Deep Fungal Infections, Blastomycosis-Like Pyoderma, and Granulomatous Sexually Transmitted Infections.

    Science.gov (United States)

    Guidry, Jacqueline A; Downing, Christopher; Tyring, Stephen K

    2015-07-01

    Granulomatous diseases are caused by multiple infectious and noninfectious causes. Deep fungal infections can present in the skin or extracutaneously, most commonly with lung manifestations. An Azole or amphotericin B is the universal treatment. Blastomycosis-like pyoderma is a clinically similar condition, which is caused by a combination of hypersensitivity and immunosuppression. Successful treatment has been reported with antibiotics and, more recently, the vitamin A analog, acitretin. Granuloma inguinale and lymphogranuloma venereum cause ulcerative genital lesions with a granulomatous appearance on histology. The Centers for Disease Control and Prevention recommens treatment of these genital infections with doxycycline. PMID:26143434

  19. Blastomycosis Presenting as Multiple Splenic Abscesses: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sami Al-Nassar

    2010-01-01

    Full Text Available A 31-year-old Canadian Aboriginal man from northwestern Ontario presented with left upper quadrant pain and a tender left upper quadrant mass. Evaluation with a computed tomography scan showed multiple lesions within the spleen, a collection between the splenic tip and splenic flexure of the colon, and several small adrenal lesions. Computed tomographic-guided needle biopsy showed necrotizing granulomatous inflammation and multinucleated giant cells. Gomori’s methenamine silver stain showed broad-based budding yeast consistent with Blastomyces dermatitidis. Abdominal symptoms resolved after two months of oral itraconazole. Multiple splenic abscesses are a rare presentation of blastomycosis and should be considered in the differential diagnosis of left upper quadrant abdominal pain in a patient with a history of travel or residence in a region endemic for B dermatitidis.

  20. Blastomicosis oral, papilomatosis laríngea y tuberculosis esofágica Oral blastomycosis, laryngeal papillomatosis and esophageal tuberculosis

    Directory of Open Access Journals (Sweden)

    Manuel Montoya

    2012-06-01

    Full Text Available El compromiso esofágico es una complicación infrecuente de la tuberculosis incluso en países con alta prevalencia de infección. Se presenta el caso de un paciente de 57 años no seropositivo al virus de inmunodeficiencia humana (VIH, con diagnóstico simultáneo de blastomicosis en cavidad oral y papilomatosis laríngea, ambas confirmadas por anatomía patológica. La biopsia de esófago reveló esofagitis granulomatosa con necrosis; la tinción de Ziehl-Neelsen mostró bacilos ácido-alcohol resistente, sugerentes de tuberculosis. El antecedente de tuberculosis pulmonar en dos oportunidades y abandono de tratamiento determinó el inicio de tratamiento antituberculoso de segunda línea a través de un tubo de gastrostomía, más itraconazol vía oral. La evolución fue favorable.Esophageal involvement is an extremely rare complication of tuberculosis even in countries with high prevalence of infection. We report the case of a 57 year-old hiv-seronegative patient with simultaneous diagnoses of oral blastomycosis and laryngeal papillomatosis. Both were confirmed by anatomopathological analysis. The esophageal biopsy revealed granulomatous esophagitis with necrosis and ziehl-neelsen stain showed acid-fast alcohol resistant bacilli suggestive of tuberculosis. The patient’s history included pulmonary tuberculosis twice and previous abandonment of therapy. Thus, it was necessary to use oral itraconazole combined with second-line anti-tuberculosis drugs administered through a gastrostomy tube. The clinical development was favorable.

  1. Case 233: Blastomycosis.

    Science.gov (United States)

    Mouser, Hans; Miller, Frank H; Berggruen, Senta M

    2016-09-01

    History A 35-year-old man from the upper Midwest region of the United States who had no relevant medical history initially presented to an acute care clinic with multiple small tender skin lesions. His temperature was 38.1°C, and physical examination revealed several small fluctuant masses that were draining purulent material. Skin culture of one of the draining lesions was performed at this time, but there was no subsequent bacterial growth. A diagnosis of furunculosis was made, and Bactrim (sulfamethoxazole-trimethoprim; AR Scientific, Philadelphia, Pa) and a regimen of chlorhexidine washes were prescribed. Two weeks later, the number of skin lesions had increased, and the patient had begun to experience night sweats and fevers. After an episode of hemoptysis and some unusual pain in the patient's right testicle, he presented to the emergency department. At this time, chest radiographs were obtained. The patient was admitted for additional work-up, and computed tomographic (CT) images of the chest were obtained. Physical examination at the time of admission revealed scattered 1-3-cm firm pink hyperpigmented subcutaneous nodules, several of which had overlying pustules. This examination was also notable for a palpable fullness within the right testicle. The patient was afebrile at admission. He denied a history of contact with sick people, illicit drug use, or recent travel. His social history was notable for a 20-pack-year smoking history and a recent relocation to a neighborhood with several new construction sites. Laboratory evaluation revealed leukocytosis (white blood cell count, 15.4 × 10(9)/L; normal range, [3.5-10.5] × 10(9)/L), a chemistry panel revealed a low sodium level (132 mEq/L [132 mmol/L]; normal range, 134-142 mEq/L [134-142 mmol/L]), and serum α-fetoprotein and human chorionic gonadotropin levels were normal. Ultrasonography (US) of the scrotum was performed. Serum analysis was negative for human immunodeficiency virus type 1 and type 2 RNA, and Venereal Disease Research Laboratory and rapid plasma regain test results were negative. Blood cultures were negative for bacterial growth. On the basis of chest CT findings, bronchoscopy with bronchoalveolar lavage was performed. Magnetic resonance (MR) imaging of the abdomen also was performed to further evaluate a focal area of hypoenhancement within the pancreatic tail seen on chest CT images. PMID:27533292

  2. Tuberculose e blastomicose laríngeas: relato de três casos e revisão de literatura Tuberculosis and blastomycosis of the larynx: report of three cases and review of literature

    Directory of Open Access Journals (Sweden)

    Roberta I. D. Garcia

    2004-04-01

    Full Text Available As doenças granulomatosas da laringe apresentam quadros polimórficos de difícil diagnóstico pelo exame clínico. São patologias que apresentam evolução favorável se o tratamento efetivo for introduzido precocemente, evitando complicações. Muitas vezes, a primeira manifestação destas patologias dá-se a nível da laringe, portanto devem ser lembradas no diagnóstico diferencial de doenças inflamatórias. Relatamos o caso de três pacientes que procuraram nosso Serviço com queixa de disfonia, sem alteração ao exame físico geral, sendo diagnosticada após a investigação tuberculose e blastomicose laríngeas.The granulomatosis diseases of the larynx have different clinical manifestations, which difficult the clinical diagnosis. When the treatment is early introduced, the result is satisfactory. The first manifestation of granulomatosis diseases can occur in larynx, and it always has to be remembered among laryngeal inflammatory diseases. We reported three cases were symptom was hoarseness, and after investigation the diagnosis was tuberculosis and blastomycosis of the larynx. The evaluation and management are discussed.

  3. Systemic Blastomycosis Diagnosed by Prostate Needle Biopsy

    OpenAIRE

    Neal, Peter M.; Nikolai, Anne

    2008-01-01

    A healthy 51-year-old man presented with a 1-month history of lower urinary tract irritative symptoms. Urinalysis was suggestive of infection, and the patient was treated with multiple antibiotics without relief of symptoms.A urological exam demonstrated abnormal induration of the prostate gland. Biopsy of the prostate gland revealed Blastomyces dermatitidis. In areas where Blastomyces dermatitidis is endemic, clinicians should be aware of the presence of this fungus and possible sites of inf...

  4. Probable Pulmonary Blastomycosis in a Wild Coyote (Canis latrans)

    OpenAIRE

    Luis E. Rodríguez-Tovar; Nevárez-Garza, Alicia M.; Ricardo Vladimir Barajas-Juárez; Juan J. Zarate-Ramos; Ledezma-Torres, Rogelio A.; Armando Trejo-Chávez

    2015-01-01

    A female coyote (Canis latrans) was fatally injured by a vehicle on a road in San Luis Potosi, Mexico. Because of deteriorating clinical signs, the animal was euthanized. Postmortem examination of the lungs showed numerous small multifocal white nodules (0.5–1 cm diameter) disseminated throughout. Histopathologic examination revealed multifocal coalescing granulomas with abundant macrophages, numerous neutrophils, fibroblasts, plasma cells, and lymphocytes. Abundant intracellular and extracel...

  5. Blastomyces: Why Be Dimorphic?

    OpenAIRE

    Baumgardner, Dennis J.

    2016-01-01

    In introducing the infectious disease focus for this edition of the Journal of Patient-Centered Research and Reviews, the author describes the unsolved mysteries surrounding the dimorphic fungus Blastomyces and the related pathogenesis of pulmonary blastomycosis.

  6. Endemic mycoses in AIDS: a clinical review.

    OpenAIRE

    Wheat, J

    1995-01-01

    Histoplasmosis and coccidioidomycosis are serious opportunistic infections in patients with AIDS who reside in areas of endemicity of the United States and Central and South America. Blastomycosis, although less common, also must be recognized as an opportunistic infection in patients with AIDS. Prompt diagnosis requires knowledge of the clinical syndromes and diagnostic tests as well as a high index of suspicion. Histoplasmosis and blastomycosis respond well to antifungal treatment, but rela...

  7. Ecologic Niche Modeling of Blastomyces dermatitidis in Wisconsin

    OpenAIRE

    Reed, Kurt D.; Meece, Jennifer K.; Archer, John R.; Peterson, A. Townsend

    2008-01-01

    Background Blastomycosis is a potentially fatal mycosis that is acquired by inhaling infectious spores of Blastomyces dermatitidis present in the environment. The ecology of this pathogen is poorly understood, in part because it has been extremely difficult to identify the niche(s) it occupies based on culture isolation of the organism from environmental samples. Methodology/Principal Findings We investigated the ecology of blastomycosis by performing maximum entropy modeling of exposure site...

  8. Mannose Receptor Is Required for Optimal Induction of Vaccine-Induced T-Helper Type 17 Cells and Resistance to Blastomyces dermatitidis Infection.

    Science.gov (United States)

    Wang, Huafeng; LeBert, Vanessa; Li, Mengyi; Lerksuthirat, Tassanee; Galles, Kevin; Klein, Bruce; Wüthrich, Marcel

    2016-06-01

    We investigated how innate sensing by the mannose receptor (MR) influences the development of antifungal immunity. We demonstrate that MR senses mannan on the surface of attenuated Blastomyces dermatitidis vaccine yeast and that MR(-/-) mice demonstrate impaired vaccine immunity against lethal experimental blastomycosis, compared with wild-type control mice. Using naive Blastomyces-specific transgenic CD4(+) T cells, we found that MR regulates differentiation of naive T cells into T-helper type 17 (Th17) effector cells, which are essential in vaccine immunity against systemic dimorphic fungi. Thus, MR regulates differentiation of Th17 cells and is required to induce vaccine immunity against lethal pulmonary blastomycosis. PMID:26931447

  9. Voriconazole Use for Endemic Fungal Infections▿

    OpenAIRE

    Freifeld, Alison; Proia, Laurie; Andes, David; Baddour, Larry M.; Blair, Janis; Spellberg, Brad; Arnold, Sandra; Lentnek, Arnold; Wheat, L. Joseph

    2009-01-01

    In a retrospective review of 24 patients with histoplasmosis, blastomycosis, or coccidioidomycosis treated with voriconazole (most for salvage therapy), the outcome was favorable (improved or stable) for 22 (95.8%) within 2 months of starting voriconazole and for 20 (83.3%) at the last follow-up. Prospective studies are required to determine its role in the treatment of endemic mycoses.

  10. Chronic diarrhea and pancolitis caused by paracoccidioidomycosis: a case report.

    Science.gov (United States)

    Bravo, Eduar A; Zegarra, Arturo J; Piscoya, Alejandro; Pinto, José L; de Los Rios, Raúl E; Prochazka, Ricardo A; Huerta-Mercado, Jorge L; Mayo, Nancy L; Tagle, Martin

    2010-01-01

    South American blastomycosis is a systemic micosis caused by infection with Paracoccidioides brasiliensis. The most frequently affected sites are the lower lip buccal mucous membrane, palate, tongue, sublingual region, lymph glands, and lungs. However, colonic involvement is not a common expression of Paracoccidioidomycosis. We report a case of chronic diarrhea and pancolitis caused by Paracoccidioidomycosis with fatal outcome. PMID:20671977

  11. Coccidioides Immitis: Two Cases of Misidentified Mycosis

    Directory of Open Access Journals (Sweden)

    Christine H Lee

    2008-01-01

    Full Text Available In the present report, two cases of pulmonary coccidioidomycosis that caused a diagnostic confusion are presented. The first case was initially misdiagnosed as nonsmall cell carcinoma, and both cases were initially misidentified as blastomycosis because of the presence of an atypical morphological form of Coccidioides immitis.

  12. Identification of the Mating-Type (MAT) Locus That Controls Sexual Reproduction of Blastomyces dermatitidis

    OpenAIRE

    Li, Wenjun; Sullivan, Thomas D.; Walton, Eric; Averette, Anna Floyd; Sakthikumar, Sharadha; Cuomo, Christina A.; Klein, Bruce S.; Heitman, Joseph

    2013-01-01

    Blastomyces dermatitidis is a dimorphic fungal pathogen that primarily causes blastomycosis in the midwestern and northern United States and Canada. While the genes controlling sexual development have been known for a long time, the genes controlling sexual reproduction of B. dermatitidis (teleomorph, Ajellomyces dermatitidis) are unknown. We identified the mating-type (MAT) locus in the B. dermatitidis genome by comparative genomic approaches. The B. dermatitidis MAT locus resembles those of...

  13. Endemic mycosis complicating human immunodeficiency virus infection.

    OpenAIRE

    Sarosi, G. A.; DAvies, S F

    1996-01-01

    Persons infected with the human immunodeficiency virus are prone to the development of many fungal diseases. Normal hosts with intact immunity usually recover from infection by these less-invasive fungi. In persons with compromised T-cell-mediated immunity, however, widespread dissemination from a pulmonary focus occurs. In this review, we discuss the epidemiology, clinical manifestations, diagnosis, and treatment of the three major North American mycoses, histoplasmosis, blastomycosis, and c...

  14. Fungal Disease in Britain and the United States 1850–2000 : Mycoses and Modernity

    OpenAIRE

    Homei, Aya; Worboys, Michael

    2013-01-01

    In this book, we discuss the changing medical and public profile of fungal infections in the period 1850–2000. We consider four sets of diseases: ringworm and athlete’s foot (dermatophytosis); thrush or candidiasis (infection with Candida albicans); endemic, geographically specific infections in North America (coccidioidomycosis, blastomycosis and histoplasmosis) and mycotoxins; and aspergillosis (infection with Aspergillus fumigatus). We discuss each disease in relation to developing medical...

  15. Pathogens spectrum of deep human mycosis

    Directory of Open Access Journals (Sweden)

    A. B. Kulko

    2012-01-01

    Full Text Available The article describes characteristics of two different etiology groups of deep human mycosis — extremely dangerous endemic deep mycoses (histoplasmosis, coccidioidomycosis, blastomycosis, paracoccidioidomycosis, penicilliosis due to Penicillium marneffei and opportunistic deep mycosis (candidiasis, cryptococcosis, aspergillosis, mucormycosis. Information on fungal pathogens and antifungal agents is presented. The own results of cultural studies obtained during pneumomycosis diagnosis in patients with tuberculosis are shown.

  16. Fungal osteomyelitis with vertebral re-ossification

    OpenAIRE

    O′Guinn, Devon J.; Serletis, Demitre; Kazemi, Noojan

    2015-01-01

    Introduction We present a rare case of thoracic vertebral osteomyelitis secondary to pulmonary Blastomyces dermatitides. Presentation of case A 27-year-old male presented with three months of chest pains and non-productive cough. Examination revealed diminished breath sounds on the right. CT/MR imaging confirmed a right-sided pre-/paravertebral soft tissue mass and destructive lytic lesions from T2 to T6. CT-guided needle biopsy confirmed granulomatous pulmonary Blastomycosis. Conservative ma...

  17. Intramedullary spinal cord paracoccidioidomycosis: report of two cases Granuloma paracoccidioidomicótico intramedular: relato de dois casos

    OpenAIRE

    Benedicto Oscar Colli; João Alberto Assirati Jr; Hélio Rubens Machado; José Fernando de Castro Figueiredo; Leila Chimelli; Carmine Porcelli Salvarani; Fábio dos Santos

    1996-01-01

    Two cases of intramedullary paracoccidioidomycosis are reported. Paracoccidioidomycosis is a systemic disease that involves the buccopharyngeal mucosa, lungs, lymph nodes and viscera and infrequently the central nervous system. Localization in the spinal cord is rare. Case 1: a 55-year old male admitted with crural pararesis, tactile/painful hypesthesia and sphincter disturbances of 15 days duration. Cutaneous-pulmonary blastomycosis was diagnosed 17 years ago. Myelotomography showed a blocka...

  18. Population Genetic Structure of Clinical and Environmental Isolates of Blastomyces dermatitidis, Based on 27 Polymorphic Microsatellite Markers ▿ †

    OpenAIRE

    Meece, Jennifer K.; Anderson, Jennifer L.; Fisher, Matthew C; Henk, Daniel A.; Sloss, Brian L; Reed, Kurt D.

    2011-01-01

    Blastomyces dermatitidis, a thermally dimorphic fungus, is the etiologic agent of North American blastomycosis. Clinical presentation is varied, ranging from silent infections to fulminant respiratory disease and dissemination to skin and other sites. Exploration of the population genetic structure of B. dermatitidis would improve our knowledge regarding variation in virulence phenotypes, geographic distribution, and difference in host specificity. The objective of this study was to develop a...

  19. Isolation, purification, and radiolabeling of a novel 120-kD surface protein on Blastomyces dermatitidis yeasts to detect antibody in infected patients

    International Nuclear Information System (INIS)

    No well-defined Blastomyces-specific antigens are currently available. We used sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting to identify immunologically active molecules in the cell wall of B. dermatitidis. A major immunoreactive 120-kD protein (WI-1) was present in all five strains studied and comprised 5% of the protein in the cell wall extract obtained after freezing and thawing yeast cells. WI-1 was recognized by serum from all 10 patients with blastomycosis but by none of those from 5 patients with histoplasmosis. It was purified by electroelution, radiolabeled with 125I, and incorporated into a radioimmunoassay (RIA) for serodiagnosis of blastomycosis. Antibody to WI-1 was detected in 58 (85%) of 68 patients with blastomycosis (geometric mean titer, 1:2,981), in two (3%) of 73 patients with histoplasmosis, coccidioidomycosis, sporotrichosis, or candidiasis (titers, 1:86 and 1:91) and in none of 44 healthy persons. WI-1 was shown to be a surface molecule abundant on B. dermatitidis yeasts that were indirectly stained with serum from a rabbit immunized with WI-1. Approximately 0.93 pg of WI-1 or 4.7 x 10(6) WI-1 molecules were found on the surface of an individual yeast using an antigen-inhibition RIA; none was found on Histoplasma capsulatum or Candida albicans yeasts. We conclude that WI-1 is a novel, immunologically active surface molecule on the invasive form of B. dermatitidis and that WI-1 can be used to reliably detect antibody and study the immunopathogenesis of blastomycosis

  20. Nocardial mycetoma: Diverse clinical presentations

    OpenAIRE

    Sharma Nand; Mahajan Vikram; Agarwal Santwana; Katoch Vishwa; Das Ram; Kashyap Meera; Gupta Poonam; Verma Ghanshyam

    2008-01-01

    Nocardia spp are gram-positive, aerobic, acid-fast bacteria which exist as saprophytes in nature. Invasive disseminated infections are particularly common in immunocompromised or debilitated hosts. Superficial infections with Nocardia spp occur as a result of local trauma and contamination of the wound. Clinically, it presents as acute infection (abscesses or cellulitis), mycetoma, or sporotrichoid infection. Differential diagnosis includes eumycetoma, chromomycosis, blastomycosis, coccidioid...

  1. PARACOCCCIDIOIDOMICOSE COM MANIFESTAÇÃO BUCAL -CASUÍSTICA EM VOLTA REDONDA-RJ NOS ANOS DE 2005 A 2008

    OpenAIRE

    Oriental Luiz de Noronha Filho; Claudio Valente

    2011-01-01

    Paracoccidioidomycosis, formerly known as South American Blastomycosis, can be installed by inhalation or by skin lesions or mucous membranes. Poor hygiene and oral diseases are theports of entry most common for this fungus, once in the bloodstream becomes systemic to infect the lungs, spleen, liver, kidneys, pancreas, bones and lymph nodes. The fungus grows on plants and soils in geographical and climatic conditions common areas of the valley of the Paraíba do Sul. The disease has preference...

  2. Pulmonary fungal infection: Imaging findings in immunocompetent and immunocompromised patients

    International Nuclear Information System (INIS)

    Histoplasmosis is the most common endemic mycosis in North America, and is followed by coccidioidomycosis and blastomycosis. Although the majority of these infections in immunocompetent persons are self-limited, some patients can develop severe pneumonitis or various forms of chronic pulmonary infection. Cryptococcoci, Aspergillus, Candidas, and Mucorals are ubiquitous organisms, which may affect immunocompromised patients. Specific imaging findings can be expected, depending on the organisms involved, underlying patients' conditions (immune status), and specific situations after immune depleting procedures

  3. Pulmonary fungal infection: Imaging findings in immunocompetent and immunocompromised patients

    Energy Technology Data Exchange (ETDEWEB)

    Chong, Semin [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Lee, Kyung Soo [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of)]. E-mail: kyungs.lee@samsung.com; Yi, Chin A [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Chung, Myung Jin [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Kim, Tae Sung [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea, Republic of); Han, Joungho [Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)

    2006-09-15

    Histoplasmosis is the most common endemic mycosis in North America, and is followed by coccidioidomycosis and blastomycosis. Although the majority of these infections in immunocompetent persons are self-limited, some patients can develop severe pneumonitis or various forms of chronic pulmonary infection. Cryptococcoci, Aspergillus, Candidas, and Mucorals are ubiquitous organisms, which may affect immunocompromised patients. Specific imaging findings can be expected, depending on the organisms involved, underlying patients' conditions (immune status), and specific situations after immune depleting procedures.

  4. Isolation, purification, and radiolabeling of a novel 120-kD surface protein on Blastomyces dermatitidis yeasts to detect antibody in infected patients.

    Science.gov (United States)

    Klein, B S; Jones, J M

    1990-01-01

    No well-defined Blastomyces-specific antigens are currently available. We used sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting to identify immunologically active molecules in the cell wall of B. dermatitidis. A major immunoreactive 120-kD protein (WI-1) was present in all five strains studied and comprised 5% of the protein in the cell wall extract obtained after freezing and thawing yeast cells. WI-1 was recognized by serum from all 10 patients with blastomycosis but by none of those from 5 patients with histoplasmosis. It was purified by electroelution, radiolabeled with 125I, and incorporated into a radioimmunoassay (RIA) for serodiagnosis of blastomycosis. Antibody to WI-1 was detected in 58 (85%) of 68 patients with blastomycosis (geometric mean titer, 1:2,981), in two (3%) of 73 patients with histoplasmosis, coccidioidomycosis, sporotrichosis, or candidiasis (titers, 1:86 and 1:91) and in none of 44 healthy persons. WI-1 was shown to be a surface molecule abundant on B. dermatitidis yeasts that were indirectly stained with serum from a rabbit immunized with WI-1. Approximately 0.93 pg of WI-1 or 4.7 x 10(6) WI-1 molecules were found on the surface of an individual yeast using an antigen-inhibition RIA; none was found on Histoplasma capsulatum or Candida albicans yeasts. We conclude that WI-1 is a novel, immunologically active surface molecule on the invasive form of B. dermatitidis and that WI-1 can be used to reliably detect antibody and study the immunopathogenesis of blastomycosis. PMID:2295693

  5. Isolation, purification, and radiolabeling of a novel 120-kD surface protein on Blastomyces dermatitidis yeasts to detect antibody in infected patients.

    OpenAIRE

    Klein, B S; Jones, J M

    1990-01-01

    No well-defined Blastomyces-specific antigens are currently available. We used sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting to identify immunologically active molecules in the cell wall of B. dermatitidis. A major immunoreactive 120-kD protein (WI-1) was present in all five strains studied and comprised 5% of the protein in the cell wall extract obtained after freezing and thawing yeast cells. WI-1 was recognized by serum from all 10 patients with blastomycosis...

  6. Isolation, purification, and radiolabeling of a novel 120-kD surface protein on Blastomyces dermatitidis yeasts to detect antibody in infected patients

    Energy Technology Data Exchange (ETDEWEB)

    Klein, B.S.; Jones, J.M.

    1990-01-01

    No well-defined Blastomyces-specific antigens are currently available. We used sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting to identify immunologically active molecules in the cell wall of B. dermatitidis. A major immunoreactive 120-kD protein (WI-1) was present in all five strains studied and comprised 5% of the protein in the cell wall extract obtained after freezing and thawing yeast cells. WI-1 was recognized by serum from all 10 patients with blastomycosis but by none of those from 5 patients with histoplasmosis. It was purified by electroelution, radiolabeled with 125I, and incorporated into a radioimmunoassay (RIA) for serodiagnosis of blastomycosis. Antibody to WI-1 was detected in 58 (85%) of 68 patients with blastomycosis (geometric mean titer, 1:2,981), in two (3%) of 73 patients with histoplasmosis, coccidioidomycosis, sporotrichosis, or candidiasis (titers, 1:86 and 1:91) and in none of 44 healthy persons. WI-1 was shown to be a surface molecule abundant on B. dermatitidis yeasts that were indirectly stained with serum from a rabbit immunized with WI-1. Approximately 0.93 pg of WI-1 or 4.7 x 10(6) WI-1 molecules were found on the surface of an individual yeast using an antigen-inhibition RIA; none was found on Histoplasma capsulatum or Candida albicans yeasts. We conclude that WI-1 is a novel, immunologically active surface molecule on the invasive form of B. dermatitidis and that WI-1 can be used to reliably detect antibody and study the immunopathogenesis of blastomycosis.

  7. Ecologic niche modeling of Blastomyces dermatitidis in Wisconsin.

    Directory of Open Access Journals (Sweden)

    Kurt D Reed

    Full Text Available BACKGROUND: Blastomycosis is a potentially fatal mycosis that is acquired by inhaling infectious spores of Blastomyces dermatitidis present in the environment. The ecology of this pathogen is poorly understood, in part because it has been extremely difficult to identify the niche(s it occupies based on culture isolation of the organism from environmental samples. METHODOLOGY/PRINCIPAL FINDINGS: We investigated the ecology of blastomycosis by performing maximum entropy modeling of exposure sites from 156 cases of human and canine blastomycosis to provide a regional-scale perspective of the geographic and ecologic distribution of B. dermatitidis in Wisconsin. Based on analysis with climatic, topographic, surface reflectance and other environmental variables, we predicted that ecologic conditions favorable for maintaining the fungus in nature occur predominantly within northern counties and counties along the western shoreline of Lake Michigan. Areas of highest predicted occurrence were often in proximity to waterways, especially in northcentral Wisconsin, where incidence of infection is highest. Ecologic conditions suitable for B. dermatitidis are present in urban and rural environments, and may differ at the extremes of distribution of the species in the state. CONCLUSIONS/SIGNIFICANCE: Our results provide a framework for a more informed search for specific environmental factors modulating B. dermatitidis occurrence and transmission and will be useful for improving public health awareness of relative exposure risks.

  8. Yeast diversity in rice-cassava fermentations produced by the indigenous Tapirapé people of Brazil

    DEFF Research Database (Denmark)

    Schwan, Rosane F.; Almeida, Euziclei G.; Souza-Dias, Maria Aparecida G.;

    2007-01-01

    The Tapirapé people of the Tapi'itãwa tribe of Brazil produce several fermented foods and beverages, one of which is called 'cauim'. This beverage usually makes up the main staple food for adults and children. Several substrates are used in its production, including cassava, rice, corn, maize and...... fermentation. Exophiala dermatidis, often associated with blastomycosis, was found in the mass before inoculation and during the initial stages of the fermentation. Examination of these indigenous fermented foods may provide clues as to how food production and preservation can be expanded and thereby...

  9. [Ecology of various tropical dermatoses in Peru].

    Science.gov (United States)

    Flores Cevallos, L

    1985-01-01

    Special circumstances: Mountains called "Los Andes", the Humbolt maritime current, subtropical region; which makes the peruvian territory present the ecosystem which influence the fauna, flora, and pothology. Contain diseases like parasite dermatosis (mal de Pinto, verruga peruana, leishmaniasis, blastomycosis and pain) have close relation with the different ecosystem of the peruvian territory. This study only includes these dermatosis and are resumed as follows: The disease called, mal del Pinto is only diffused in the arid coast, andean valleys and the virgin forest (it is found in altitudes of 800 to 1,000 m.). The verruga peruvian: Is found in the occidental part of the andean valleys (at 800 and 1,000 m. of altitude). Leishmaniasis exist in two forms: One like bottom of orient with only skin alteration called leishmaniasis andina (uta for the indians), its propagated in the coast and the andean valleys at 200 m. (amount 1,200 to 3,000); the otter form affects the mycosis, called leishmaniasis americana (espundia for the indians), its it propagates general in the virgin forest. The brazilian blastomycosis only exists in the virgin forest. The pain, disease does not exist in the arid coast, nor in the andean valleys. Geographically, for its propagation it is necessary heat, humidity and heavy rainy water, that is why it is only found in the virgin forest. PMID:3914595

  10. The Dynamic Genome and Transcriptome of the Human Fungal Pathogen Blastomyces and Close Relative Emmonsia.

    Directory of Open Access Journals (Sweden)

    José F Muñoz

    2015-10-01

    Full Text Available Three closely related thermally dimorphic pathogens are causal agents of major fungal diseases affecting humans in the Americas: blastomycosis, histoplasmosis and paracoccidioidomycosis. Here we report the genome sequence and analysis of four strains of the etiological agent of blastomycosis, Blastomyces, and two species of the related genus Emmonsia, typically pathogens of small mammals. Compared to related species, Blastomyces genomes are highly expanded, with long, often sharply demarcated tracts of low GC-content sequence. These GC-poor isochore-like regions are enriched for gypsy elements, are variable in total size between isolates, and are least expanded in the avirulent B. dermatitidis strain ER-3 as compared with the virulent B. gilchristii strain SLH14081. The lack of similar regions in related species suggests these isochore-like regions originated recently in the ancestor of the Blastomyces lineage. While gene content is highly conserved between Blastomyces and related fungi, we identified changes in copy number of genes potentially involved in host interaction, including proteases and characterized antigens. In addition, we studied gene expression changes of B. dermatitidis during the interaction of the infectious yeast form with macrophages and in a mouse model. Both experiments highlight a strong antioxidant defense response in Blastomyces, and upregulation of dioxygenases in vivo suggests that dioxide produced by antioxidants may be further utilized for amino acid metabolism. We identify a number of functional categories upregulated exclusively in vivo, such as secreted proteins, zinc acquisition proteins, and cysteine and tryptophan metabolism, which may include critical virulence factors missed before in in vitro studies. Across the dimorphic fungi, loss of certain zinc acquisition genes and differences in amino acid metabolism suggest unique adaptations of Blastomyces to its host environment. These results reveal the dynamics

  11. In Search for Equilibrium: Immunosuppression Versus Opportunistic Infection.

    Science.gov (United States)

    Yousuf, Tariq; Kramer, Jason; Kopiec, Adam; Jones, Brody; Iskandar, Joy; Ahmad, Khansa; Keshmiri, Hesam; Dia, Muhyaldeen

    2016-02-01

    Post-transplant immunosuppression is necessary to prevent organ rejection. Immunosuppression itself can introduce complications arising from opportunistic infections. We present a case of disseminated blastomycosis manifested only as a skin lesion in an asymptomatic patient post-orthotopic heart transplantation. A 64-year-old female who had recently undergone orthotopic heart transplant for end-stage ischemic cardiomyopathy presented for a scheduled routine cardiac biopsy. The patient had no current complaints other than a crusted plaque noticed at her nasal tip. It initially manifested 6 months after surgery as a pimple that she repeatedly tried to manipulate resulting in redness and crust formation. Her immunosuppressive and prophylactic medications included: mycophenolate, tacrolimus, prednisone, bactrim, acyclovir, valganciclovir, pyrimethamine/sulfadiazine, and fluconazole. On physical examination, she was flushed, with a large and exquisitely tender crusted necrotic lesion involving almost the entire half of the nose anteriorly, the left forehead and right side of the neck. She had decreased air entry over the right lung field as well. A computed tomography (CT) image of the chest was ordered to investigate this concerning physical exam finding in the post-transplant state of this patient on immunosuppressive therapy. Chest CT revealed bilateral nodular pulmonary infiltrates with confluence in the posterior right upper lobe. Blood cultures for aerobic and anerobic organisms were negative. Both excisional biopsy of the nasal cutaneous ulcer and bronchial biopsy demonstrated numerous fungal yeast forms morphologically consistent with Blastomyces. Cultures of both specimens grew Blastomyces dermatitidis, with methicillin-resistant Staphylococcus aureus (MRSA) superinfection of the nose. She received 14 days of intravenous (IV) amphotericin B for disseminated blastomycosis and 7 days of IV vancomycin for MRSA. Her symptoms and cutaneous lesions improved and she

  12. Nocardial mycetoma: Diverse clinical presentations

    Directory of Open Access Journals (Sweden)

    Sharma Nand

    2008-01-01

    Full Text Available Nocardia spp are gram-positive, aerobic, acid-fast bacteria which exist as saprophytes in nature. Invasive disseminated infections are particularly common in immunocompromised or debilitated hosts. Superficial infections with Nocardia spp occur as a result of local trauma and contamination of the wound. Clinically, it presents as acute infection (abscesses or cellulitis, mycetoma, or sporotrichoid infection. Differential diagnosis includes eumycetoma, chromomycosis, blastomycosis, coccidioidomycosis, sporotrichosis, tuberculosis, botryomycosis, syphilis, yaws, and neoplasia. Its diagnosis is confirmed by demonstrating the causative organism in exudates (as granules, tissue specimens, or cultures. Early diagnosis will obviate need for drastic surgical measures as early institution of chemotherapy is effective in most patients. However, its diagnosis is often delayed due to diverse clinical presentations and for want of clinical suspicion, particularly in non-endemic areas. This paper presents 4 clinical forms of this not so uncommon disease, emphasizing the importance of high index of clinical suspicion, especially in non-endemic regions; and the significance of repeated examination of exudates for Nocardia granules for an early diagnosis.

  13. PARACOCCCIDIOIDOMICOSE COM MANIFESTAÇÃO BUCAL -CASUÍSTICA EM VOLTA REDONDA-RJ NOS ANOS DE 2005 A 2008

    Directory of Open Access Journals (Sweden)

    Oriental Luiz de Noronha Filho

    2011-01-01

    Full Text Available Paracoccidioidomycosis, formerly known as South American Blastomycosis, can be installed by inhalation or by skin lesions or mucous membranes. Poor hygiene and oral diseases are theports of entry most common for this fungus, once in the bloodstream becomes systemic to infect the lungs, spleen, liver, kidneys, pancreas, bones and lymph nodes. The fungus grows on plants and soils in geographical and climatic conditions common areas of the valley of the Paraíba do Sul. The disease has preferences for males, for white and aged between 41 and 50. The primary lesion compromises the oral tongue, gums, lips and other mucous, isolated or associated. The oral lesions appear as lesions located andbulky appearance of micro granules, resembling a blackberry. This study examined medical records of the Municipal Health Department of Volta Redonda, whose primary lesion was in the mouth. We selected 11patient records that corroborated with the literary data, emphasizing the language as the most affected andthe association with bad oral hygiene and oral habits such as smoking and alcohol consumption. All evaluated had pulmonary infection and were treated clinically by the administration of sulfa drugs, outpatient and six to twelve months. It was concluded this could be an endemic area and the importance of the role of the Dental Surgeon in the diagnosis of the disease.

  14. Pulmonary fungal infections.

    Science.gov (United States)

    Smith, Jeannina A; Kauffman, Carol A

    2012-08-01

    This review details some of the advances that have been made in the recent decade in the diagnosis, treatment and epidemiology of pulmonary fungal infections. These advances have occurred because of increasing knowledge regarding the fungal genome, better understanding of the structures of the fungal cell wall and cell membrane and the use of molecular epidemiological techniques. The clinical implications of these advances are more rapid diagnosis and more effective and less toxic antifungal agents. For example, the diagnosis of invasive pulmonary aspergillosis, as well as histoplasmosis and blastomycosis, has improved with the use of easily performed antigen detection systems in serum and bronchoalveolar lavage fluid. Treatment of angioinvasive moulds has improved with the introduction of the new azoles, voriconazole and posaconazole that have broad antifungal activity. Amphotericin B is less frequently used, and when used is often given as lipid formulation to decrease toxicity. The newest agents, the echinocandins, are especially safe as they interfere with the metabolism of the fungal cell wall, a structure not shared with humans cells. Epidemiological advances include the description of the emergence of Cryptococcus gattii in North America and the increase in pulmonary mucormycosis and pneumonia due to Fusarium and Scedosporium species in transplant recipients and patients with haematological malignancies. The emergence of azole resistance among Aspergillus species is especially worrisome and is likely related to increased azole use for treatment of patients, but also to agricultural use of azoles as fungicides in certain countries. PMID:22335254

  15. PCR Based Diagnosis of Fungal Diseases in Dogs

    Directory of Open Access Journals (Sweden)

    Idress Hamad Attitalla

    2012-01-01

    Full Text Available Interaction with animals provide necessary companionship and helps people to live better life by reducing risk of many health problems, improved fitness and act as a source of social enjoyment. In modern society there is a substantial increase in the number of dogs adopted as pet which also raises the concerns regarding the transmission of infections from dog to their owners and vice versa. Early diagnosis of infected dogs could prevent the owners from these infections. In last decade, PCR has proven its potential applications as an important diagnostic tool but these applications are mainly limited to the diagnosis of human diseases and very little work has been done on animals. Development of PCR assays for detection of commonly found canine fungal infections (aspergillosis, blastomycosis, coccidioidomycosis and cryptococcosis is of utmost importance in order to ensure the early and accurate diagnosis of infection. Although, a lot of research is being done on molecular diagnosis of animal infectious disease but most of these newly developed assays are either not well optimized or only suitable for laboratory studies. On the basis of reviewed literature it can be concluded that more research work is required to develop an efficient (rapid, sensitive and cost effective PCR assays for the diagnosis of canine fungal infections.

  16. Keratoacanthoma centrifugum marginatum: unresponsive to oral retinoid and successfully treated with wide local excision.

    Directory of Open Access Journals (Sweden)

    Kapildev Das

    2010-01-01

    Full Text Available We describe a case of a 65-year-old male presenting with a large plaque with a rolled-out interrupted margin, atrophic center, and island of normal skin over the left arm. It grew peripherally with central healing, and there was a history of recurrence after inadequate excision. Investigations ruled out other clin­ical mimickers; namely, squamous cell carcinoma, lupus vulgaris, botryomycosis, and blastomycosis-like pyoderma. Histopathological sections showed irregularly shaped craters filled with keratin and epithelial pearl but no evidence of granuloma or cellular atypia. Clinico­pathological correlation proved the lesion to be keratoacanthoma centrifugum marginatum (KCM, a rare variant of keratoacanthoma, which spreads centrifugally, attains a huge size, and never involutes spontaneously. Treatment of KCM has been a problem always and, in our case, systemic retinoid (acitretin for three months proved ineffective. The patient also had a history of recurrence following surgical intervention previously, necessitating wide excision to achieve complete clearance of tumor cells. Hence, after failure of retinoid therapy, the decision of excision with a 1-centimeter margin was taken and the large defect was closed by a split thickness skin graft. The graft uptake was satisfactory, and the patient is being followed-up presently and shows no signs of recurrence after six months, highlighting wide local excision as a useful treatment option.

  17. Lesões neurológicas na blastomicose sul-americana estudo anatomopatológico de 14 casos

    Directory of Open Access Journals (Sweden)

    Walter C. Pereira

    1965-06-01

    Full Text Available Several case reports of involvement of the nervous system by Paracoccidioides brasiliensis have been published, changing thus the concept that the nervous system would no be adequate to the proliferation of this fungus. In the material of the Department of Pathology of the University of São Paulo Medical School, collected up to September 1964, 145 cases of paracoccidioidomycosis were found. In 14 of them there were lesions of the nervous system, giving an incidence of 9,65%. This high incidence contradicts the frequent assumption that the involvement of the nervous system in cases of South American blastomycosis is exceptional. In our material most of the cases of neuroblastomycosis had not systemic lesions, 2 of them having isolated involvement of the nervous system. This fact does not agree with the frequent observation of patients with lesions in all organs but the nervous system. There are no pathophysiologic reasons to explain such contradiction, but it can be assumed that individual conditions, in some cases, make the nervous system vulnerable to the parasite. Of the 14 cases studied, 5 had lesions of the meninges and 9 had gra-nulomata of the brain. Of the 5 cases with meningitis, 3 had an isolated basilar leptomeningitis; in 1 case lesions of the pia-arachnoid of the brain convexity were also found, and in another one the spinal meninges were also involved as well the spinal roots. The granulomata of the brain were isolated in 5 cases and multiple in 4. The most frequent site of the lesions was the cerebral hemispheres (6 cases; in 2 cases the cerebellum was involved; the thalamus, pons and medulla were involved in one case each. This predominance of the hemispheric localization must be related to the larger blood supply of this parte of the nervous system, owing to the hematogenic route followed by the parasite. In our material no lesions of the spinal cord were found. However, no definitive conclusions can be drawn, as there was no

  18. Intramedullary spinal cord paracoccidioidomycosis. Report of two cases.

    Science.gov (United States)

    Colli, B O; Assirati Júnior, J A; Machado, H R; Figueiredo, J F; Chimelli, L; Salvarani, C P; Dos Santos, F

    1996-09-01

    Two cases of intramedullary paracoccidioidomycosis are reported. Paracoccidioidomycosis is a systemic disease that involves the buccopharyngeal mucosa, lungs lymph nodes and viscera and infrequently the central nervous system. Localization in the spinal cord is rare. Case 1: a 55-year old male admitted with crural pararesis, tactile/painful hypesthesia and sphincter disturbances of 15 days duration. Cutaneous-pulmonary blastomycosis was diagnosed 17 years ago. Myelotomography showed a blockade of T3-T4 (intramedullary lesion). The lesion surgically removed was a Paracoccidioides brasiliensis granuloma. Treatment with sulfadiazine was started after the surgery. Follow-up of 15 month showed an improvement of the clinical signs. Case 2: a 57-year old male was admitted elsewhere 6 months ago and, with a radiologic diagnosis of pulmonary paracoccidioidomycosis, was treated with amphotericin B. He progressively developer paresthesia and tactile/pain anaesthesia on the left side, sphincter disturbances and tetraparesis with bilateral extensor plantar response and clonus of the feet. Myelotomography showed a blockade of C4-C6 (intramedullary lesion). The lesion was not found during surgical exploration and the patient deteriorated and died. Post-mortem examination revealed an intramedullary tumor above the site of the mielotomy (Paracoccidioides brasiliensis granuloma). The preoperative diagnosis of intramedullary paracoccidioidomycotic granulomas is difficult because the clinical and radiologic manifestations are uncharacteristic. Clinical suspicion was possible in our cases based on the history of previous systemic disease. Contrary to intracranial localizations, paracoccidioidomycotic granulomas causing progressive spinal cord compression may require early surgery because response to clinical treatment is slow and the reversibility of neurological deficits depends on the promptness of the decompression. PMID:9109993

  19. Phylogenetic analysis reveals a cryptic species Blastomyces gilchristii, sp. nov. within the human pathogenic fungus Blastomyces dermatitidis.

    Directory of Open Access Journals (Sweden)

    Elizabeth M Brown

    Full Text Available BACKGROUND: Analysis of the population genetic structure of microbial species is of fundamental importance to many scientific disciplines because it can identify cryptic species, reveal reproductive mode, and elucidate processes that contribute to pathogen evolution. Here, we examined the population genetic structure and geographic differentiation of the sexual, dimorphic fungus Blastomyces dermatitidis, the causative agent of blastomycosis. METHODOLOGY/PRINCIPAL FINDINGS: Criteria for Genealogical Concordance Phylogenetic Species Recognition (GCPSR applied to seven nuclear loci (arf6, chs2, drk1, fads, pyrF, tub1, and its-2 from 78 clinical and environmental isolates identified two previously unrecognized phylogenetic species. Four of seven single gene phylogenies examined (chs2, drk1, pyrF, and its-2 supported the separation of Phylogenetic Species 1 (PS1 and Phylogenetic Species 2 (PS2 which were also well differentiated in the concatenated chs2-drk1-fads-pyrF-tub1-arf6-its2 genealogy with all isolates falling into one of two evolutionarily independent lineages. Phylogenetic species were genetically distinct with interspecific divergence 4-fold greater than intraspecific divergence and a high Fst value (0.772, P<0.001 indicative of restricted gene flow between PS1 and PS2. Whereas panmixia expected of a single freely recombining population was not observed, recombination was detected when PS1 and PS2 were assessed separately, suggesting reproductive isolation. Random mating among PS1 isolates, which were distributed across North America, was only detected after partitioning isolates into six geographic regions. The PS2 population, found predominantly in the hyper-endemic regions of northwestern Ontario, Wisconsin, and Minnesota, contained a substantial clonal component with random mating detected only among unique genotypes in the population. CONCLUSIONS/SIGNIFICANCE: These analyses provide evidence for a genetically divergent clade within

  20. Lacaziose (doença de Jorge Lobo: revisão e atualização Lacaziosis (Jorge Lobo’s disease: review and update

    Directory of Open Access Journals (Sweden)

    Arival Cardoso de Brito

    2007-10-01

    Full Text Available Lacaziose ou doença de Jorge Lobo é micose crônica, granulomatosa, causada por implantação traumática do fungo Lacazia loboi - patógeno não cultivável até o presente - nos tecidos cutâneo e subcutâneo, manifestando-se clinicamente por lesões nodulares queloidianas predominantes, envolvendo sobretudo pavilhões auriculares, face, membros superiores e inferiores, e não comprometendo as mucosas. A maioria dos casos humanos está registrada em países da América do Sul. Entretanto, a enfermidade apresenta aspectos epidemiológicos destacados, como o aparecimento em tribo Caiabi, no Brasil Central e em mamíferos não humanos, golfinhos de duas espécies (Tursiops truncatus e Sotalia guianensis capturados na costa da Flórida (EUA, na foz do rio Suriname, na costa de Santa Catarina (Brasil, no golfo de Gasconha (baía de Biscaia-Europa, com manifestações cutâneas e achados histopatológicos muito similares às encontradas no homem. O artigo objetiva abordar características do fungo e sua taxonomia, e aspectos históricos, ecoepidemiológicos, clínicos, imuno-histoquímicos, histopatológicos, ultra-estruturais e terapêuticos.Lacaziosis, also known as Jorge Lobo’s disease, lobomycosis and keloidal blastomycosis, is a chronic cutaneous and subcutaneous fungal granulomatous disease, caused by Lacazia loboi - an uncultivated fungal pathogen - characterized by the development of nodular keloidal lesions, particularly on the pinnae, face, upper and lower limbs, and with no involvement of mucous membranes. Most cases in humans were reported in South America, including the Caiabi Indians, in Central Brazil. The disease was described in non-human mammals, such as two species of dolphins (Tursiops truncatus and Sotalia guianensis inhabiting the coasts of Florida (USA, South America (Suriname River estuary, Santa Catarina-Brazil coast and Gulf of Gascony (Biscaya Bay, in Europe. The histopathological findings in dolphins were very similar

  1. Intramedullary spinal cord paracoccidioidomycosis: report of two cases Granuloma paracoccidioidomicótico intramedular: relato de dois casos

    Directory of Open Access Journals (Sweden)

    Benedicto Oscar Colli

    1996-09-01

    Full Text Available Two cases of intramedullary paracoccidioidomycosis are reported. Paracoccidioidomycosis is a systemic disease that involves the buccopharyngeal mucosa, lungs, lymph nodes and viscera and infrequently the central nervous system. Localization in the spinal cord is rare. Case 1: a 55-year old male admitted with crural pararesis, tactile/painful hypesthesia and sphincter disturbances of 15 days duration. Cutaneous-pulmonary blastomycosis was diagnosed 17 years ago. Myelotomography showed a blockade of T3-T4 (intramedullary lesion. The lesion surgically removed was a Paracoccidioides brasiliensis granuloma. Treatment with sulfadiazine was started after the surgery. Follow-up of 15 month showed an improvement of the clinical signs. Case 2: a 57-year old male was admitted elsewhere 6 months ago and, with a radiologic diagnosis of pulmonary paracoccidioidomycosis, was treated with amphotericin B. He progressively developed paresthesia and tactile/ pain anaesthesia on the left side, sphincter disturbances and tetraparesis with bilateral extensor plantar response and clonus of the feet. Myelotomography showed a blockade of C4-C6 (intramedullary lesion. The lesion was not found during surgical exploration and the patient deteriorated and died. Post-mortem examination revealed an intramedullary tumor above the site of the mielotomy (Paracoccidioides brasiliensis granuloma. The preoperative diagnosis of intramedullary paracoccidioidomycotic granulomas is difficult because the clinical and radiologic manifestations are uncharacteristic. Clinical suspicion was possible in our cases based on the history of previous systemic disease. Contrary to intracranial localizations, paracoccidioidomycotic granulomas causing progressive spinal cord compression may require early surgery because response to clinical treatment is slow and the reversibility of neurological deficits depends on the promptness of the decompression.São relatados dois casos de granuloma blastomic

  2. The Infectious and Noninfectious Dermatological Consequences of Flooding: A Field Manual for the Responding Provider.

    Science.gov (United States)

    Bandino, Justin P; Hang, Anna; Norton, Scott A

    2015-10-01

    can remain latent for many years before presenting as the host's immunocompetence wanes. It can present with a variety of skin findings or as a nonspecific febrile illness, and preferred treatment consists of ceftazidime or a carbapenem with trimethoprim/sulfamethoxazole (TMP/SMX) for 2 weeks, then continuing TMP/SMX for at least 3 months. Leptospirosis is a waterborne zoonosis that is often prevalent after heavy rains or flooding. Different forms exist, including Fort Bragg fever, which produces a distinctive erythematous papular rash on the shins. Doxycycline is often sufficient; however, volume and potassium repletion may be necessary if renal involvement exists. Chromobacterium violaceum infection may occur after open skin is exposed to stagnant or muddy water. Cultured colonies produce a unique violacein pigment, and treatment typically consists of a carbapenem. Both typical and atypical fungal infections are increased in the flooding disaster scenario, such as dermatophytosis, chromoblastomycosis, blastomycosis, and mucormycosis. Appropriate antifungals should be used. In addition, land inundated with water expands the habitat for parasites and/or vectors, thus increased vigilance for regional parasitic infections is necessary after a flood. Lastly, noninfectious consequences of a flooding disaster are also common and include miliaria, immersion foot syndromes, irritant and allergic contact dermatitis, traumatic wounds and animal bites, and arthropod assault, as well as exacerbation of existing skin conditions such as atopic dermatitis, psoriasis, and alopecia areata due to increased stress or nonavailability of daily medications. PMID:26159354

  3. Paracoccidioidomicosis en cavidad oral Oral cavity paracoccidioidomycosis

    Directory of Open Access Journals (Sweden)

    D. Antunes Freitas

    2012-02-01

    completamente y el paciente continúa bajo control en el servicio.Paracoccidioidomycosis (PCM or South-american Blastomycosis is the most important systemic mycosis in Latin America, is relatively common in Brazil, Venezuela, Colombia, Ecuador and Argentina. Sporadic cases can also be seen in some other countries, which is a rare progressive and fatal if not treated. It has been regarded as a multifocal disease with oral lesions as the prominent feature. It is caused by a dimorphic fungus, Paracoccidioides brasiliensis, which mainly affects the skin, lymph nodes, lungs and mucous membranes, oral, nasal and gastrointestinal. Depending on the specific immunity of the host, the infection can take many forms and affects one or more organs, becoming a serious and potentially fatal disease. It is very important for health professionals worldwide have knowledge about Paracoccidioidomycosis because sometimes the disease only manifests itself many years after you have left the endemic area. To provide useful information about the diagnosis and treatment of disease A case report of case of male patient 48 years old from a rural area of Brazil Oath, presenting multiple painful ulcers on the gums and palate of 3 months duration, referred to chronic smoking history, clinical examination extraoral lesions are discarded in other intraoral examination bodies and multiple ulcers were observed necrotic and granulomatous background located on the gums and palate. We performed an incisional biopsy of the lesion and the material was sent for pathologic examination. The pathology report confirmed the clinical impression of Paracoccidioidomycosis. The patient was treated with the use of sulfamethoxazole + trimethoprim - 800/60 mg/day, orally every 12 hours for 30 days. The oral lesions disappeared completely and the patient remains under control in the service.