Disseminated infection caused by novel species of Microsporidium, Thailand.
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ABSTRACT:
SUBMITTER: Suankratay C
PROVIDER: S-EPMC3310463 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:We report the first establishment of in vitro cultivation and genotypic characterization of Leishmania siamensis isolated from an autochthonous disseminated dermal and visceral leishmaniasis in a Thai acquired immunodeficiency syndrome (AIDS) patient. The molecular identification has shown that the parasite was identical to L. siamensis, a recently described Leishmania species reported in the southern provinces of Thailand. The phylogenetic analysis has confirmed L. siamensis as closely related to the zoonotic Leishmania species L. enrietti.
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Project description:INTRODUCTION: Nocardial infections, although rare, are challenging for clinicians to treat. Recent contradictory reports of sulfonamide resistance have raised concerns about using this drug to treat nocardial infections. CASE PRESENTATION: A 62-year-old immunocompetent Caucasian woman showed disseminated pulmonary nodules and a brain abscess by chest computed tomography and brain magnetic resonance imaging, respectively. Multidrug-resistant Nocardia wallacei was cultured from a stereotactic brain biopsy and confirmed by 16S ribosomal ribonucleic acid gene sequencing. After the first-line treatment failed, a long course of trimethoprim-sulfamethoxazole was prescribed with no evidence of recurrence. To the best of our knowledge, this is the first report of a Nocardia wallacei disseminated infection in an immunocompetent patient, and it is the first detailed description of successful treatment with trimethoprim-sulfamethoxazole despite the resistance observed in vitro. CONCLUSION: Species identification of clinical isolates is critical for diagnosis, a prediction of antimicrobial susceptibility and epidemiological tracking. In the case of Nocardia wallacei, the clinical outcome suggests that sulfonamides can be used for treatment despite ambiguous results from in vitro susceptibility tests.
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Project description:Abstract Background A 68-year-old woman with hypogammaglobulinemia and prior treated lymphoma presented with fever and abdominal pain. Evaluation revealed numerous nodules in the lung, eye, brain, and liver (Figure 1). Initial lung and liver biopsies showed necrotizing granulomas with no organisms and negative serology and cultures. After progression while on broad-spectrum antibiotics for 4 months, an open liver biopsy revealed numerous nodular lesions and a mass made up of multifocal coalescing cystic lesions. The mass consisted of a degenerating 3-layered membrane without scoleces characterized by a wavy protuberant ciliated eosinophilic outer layer, subjacent degenerating cells with pyknotic nuclei, and loose connective tissue suggestive of a bladder wall and calcareous corpuscles in a matrix of granulomatous inflammation with areas of necrosis (Figure 2). This was diagnostic of disseminated metacestodes (larval stage) of a cestode (tapeworm). Treatment with praziquantel and albendazole led to improvement of symptoms and lesions. Disseminated cestode infections other than due to Echinococcus species are rare in humans. Sequencing was pursued due to the unusual findings. Methods DNA was extracted from liver tissue followed by targeted amplification of the cestode COX1 gene. PCR products confirmed to be 134 bp, as expected for a cestode COX1 gene, then inserted into a 2.1 Topo vector and cloned. Five separate isolates were sequenced, and 4 were interpretable. The 129-bp consensus sequence is shown in Figure 3. Basic Local Alignment Search Tool (NCBI BLAST) was used to find highly similar sequences. Results The sequence matched to Versteria sp. (T. mustelae) COX1 gene from a mink in Oregon (accession KT223034) with 98% identity. Conclusion Metacestodes have the propensity to proliferate and rarely disseminate. There is one reported case of Versteria sp. causing a lethal disseminated infection of an orangutan. This is the first report of a Versteria sp. disseminated infection in a human and is singular because the patient survived. The patient likely accidentally ingested ova shed from a tapeworm in a mink or similar mammalian host. Histopathologic assessment is crucial in diagnosing cestode infection. COX1 gene sequencing is useful for cestode identification. Disclosures All authors: No reported disclosures.
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Project description:Abstract Mucor species are common fast-growing fungi found in soil. Two new species of Mucor and one new geographical record of M.nederlandicus were collected from northern Thailand and are described in this study. Evidence from morphophysiological data and phylogenetic analysis supports the introduction of the new taxa. Phylogenetic analysis based on the internal transcribed spacer (ITS) and large subunit of the nuclear ribosomal RNA (LSU) data showed that the new isolates cluster distinctly from other Mucor species with high or maximum bootstrap support. Mucoraseptatophorus is characterized by aseptate sporangiophores, globose columella, resistant and deliquescent sporangia, has sympodial, and monopodial branches and shows growth at 37 °C. It also differs from M.irregularis in having smaller sporangiospores, and larger sporangia. Mucorchiangraiensis has subglobose or slightly elongated globose columella, produces hyaline sporangiospores, and resistant and deliquescent sporangia. Furthermore, this species has wider sporangiophore, smaller sporangia and lower growth than M.nederlandicus. A detailed description of the species and illustrations are provided for the novel species.
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Project description:A patient in Pennsylvania, USA, with common variable immunodeficiency sought care for fever, cough, and abdominal pain. Imaging revealed lesions involving multiple organs. Liver resection demonstrated necrotizing granulomas, recognizable tegument, and calcareous corpuscles indicative of an invasive cestode infection. Sequencing revealed 98% identity to a Versteria species of cestode found in mink.
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Project description:Trichosporon spp. are heavily arthroconidiating fungi and widely distributed in nature. Due to the similar fungal morphology, confusion among Trichosporon spp., Geotrichum spp., and Nannizziopsis spp. in reptiles is apparent and cannot be overlooked. Although few reptile Trichosporon isolates have been examined using the newer speciation criteria, the information on Trichosporon asahii in reptiles is still scarce. In the present study, we report the case of disseminated fungal infection and fungemia caused by T. asahii in a captive plumed basilisk (Basiliscus plumifrons). Multiple 0.2-0.5 cm, irregularly shaped, ulcerative nodules on the left hind foot were observed. The animal died due to the non-responsiveness to treatment. A microscopic evaluation revealed the fungal infection that primarily affected the left hind foot and right lung lobe with fungal embolisms in the lung and liver. The molecular identification of the fungal species by the DNA sequences of the ITS regions and D1/D2 gene from the fungal culture and ITS regions, from formalin-fixed paraffin-embedded (FFPE) lung tissues, were completely matched to those of T. asahii. The current report describes the first confirmed case of disseminated fungal infection and fungemia caused by T. asahii in a captive plumed basilisk.
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