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Epidemiology of fungal infections: What, where, and when
Published in Mahmoud A. Ghannoum, John R. Perfect, Antifungal Therapy, 2019
Frederic Lamoth, Sylvia F. Costa, Barbara D. Alexander
Blastomyces dermatitidis is the dimorphic fungus causing blastomycosis (also called North American blastomycosis). B. dermatitidis grows on decaying organic material. In North America, the fungus is found in the south central and southeastern states, states bordering the Mississippi and Ohio River basins, the Canadian provinces and Midwest states that border the Great Lakes, and areas of Canada and New York along the St. Lawrence River, although cases west of the Mississippi River Valley have also been reported [302,303]. Africa is also considered an endemic region for blastomycosis [5]. The portal of entry is via inhalation of conidia; in the alveoli, transformation to the yeast form takes place with an inflammatory response generating granulomata. Specific cell-mediated immunity is the major host defense system to prevent dissemination. Most infected individuals are asymptomatic. The clinical presentation of pulmonary blastomycosis is varied and includes flu-like illness, acute pneumonia, subacute or chronic respiratory illness, or fulminant ARDS; verrucous or ulcerative cutaneous lesions have also been reported [5,304].
Amphotericin B Deoxycholate
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Neil R. H. Stone, Tihana Bicanic
Blastomyces dermatitidis, Paracoccidioides brasiliensis, Histoplasma capsulatum, and Coccidioides immitis are routinely susceptible (Li et al., 2000); most isolates have an MIC of 0.5–1 µg/ml. An early in vitro study of clinical isolates found a high rate of resistance in C. immitis (20%) (Hoeprich and Huston, 1975), but subsequent studies have found low MICs to be the norm, with AMB effective treatment in murine models (Collins and Pappagianis, 1977) and in clinical practice (Drutz, 1983).
Fungal infections in lung transplantation
Published in Wickii T. Vigneswaran, Edward R. Garrity, John A. Odell, LUNG Transplantation, 2016
Blastomycosis is the clinical syndrome caused by Blastomyces dermatitidis, which is distributed in the Upper Midwest, Great Lakes region, South Central states and St. Lawrence River area in North America.97 Blastomycosis in SOT recipients is rare, with an incidence of only 0.14%.95 Like histoplasmosis, blastomycosis typically involves a spectrum of illness ranging from mild acute pneumonia to severe pneumonia, which may progress to fulminant infection with multiorgan failure. Extrapulmonary involvement is reported in 25% to 40% of those infected and can be manifested as cutaneous, osteoarticular, genitourinary, or CNS disease.98 Immunocompromised individuals often have severe pneumonia or disseminated disease.91,99 To date, the largest series of blastomycosis in SOT recipients has included 11 patients (1 lung transplant recipient).97 Most patients had severe pneumonia, and disseminated disease with cutaneous involvement developed in one third of them. The overall mortality rate in SOT recipients is 36%.
The unforeseen intracellular lifestyle of Enterococcus faecalis in hepatocytes
Published in Gut Microbes, 2022
Natalia Nunez, Aurélie Derré-Bobillot, Nicolas Trainel, Goran Lakisic, Alexandre Lecomte, Françoise Mercier-Nomé, Anne-Marie Cassard, Hélène Bierne, Pascale Serror, Cristel Archambaud
The concept of an intracellular lifestyle has emerged quite recently for several opportunistic pathogens generally recognized as extracellular pathogens. O’Neill et al. (2016) provided the first direct evidence of group A Streptococcus replication inside human macrophages.38 Since then, intracellular replication of Streptococcus pneumoniae has also been observed in splenic macrophages.39 Staphylococcus aureus, which was historically regarded as a classical toxin-producing extracellular pathogen, is now widely accepted as a facultative intracellular pathogen.40 Very recently, Salcedo’s group described an intracellular niche for Acinetobacter baumannii, another nocosomial pathogen mainly described as an extracellular pathogen with restricted survival within cells.41 Some pathogenic fungi, such as Blastomyces dermatitidis, can also display a facultative intracellular lifestyle.42 Based on our findings and others,18,23E. faecalis can grow intracellularly and form microcolonies in hepatocytes, in kidney cells and in urothelial cells. In line with the contribution of E. faecalis to liver damage in alcoholic liver disease and its incidence with urinary tract infections, the liver, bladder, and kidneys are relevant target tissues. Future investigations on E. faecalis intracellular lifestyle will make sense, especially in light of the variety of organs or host sites targeted by E. faecalis.
Inhaled antifungal therapy: benefits, challenges, and clinical applications
Published in Expert Opinion on Drug Delivery, 2022
The incidence of fungal infections has increased substantially over the past two decades. Currently, over 300 million people are afflicted with a serious fungal infection and the annual mortality associated with fungal infections is more than 1.6 million worldwide [1]. For pulmonary mycoses, invasive forms are associated with high morbidity and mortality rates [2]. Those who are non-immunocompetent or have impaired lung function such as patients who suffer from Coronavirus disease 2019 (COVID19), influenza, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), tuberculosis (TB), cancers, chronic obstructive pulmonary disease (COPD), and asthma are at high risk of fungal infection [3,4]. The primary cause of pulmonary fungal infections consists of several fungal species including Aspergillus spp., Mucor spp., Fusarium spp., Scedosporium spp., Blastomyces dermatitidis, Coccidioides spp., Cryptococcus spp., Histoplasma spp., Paracoccidioides brasiliensis, and Pneumocystis jirovecii [5–7]. This review will largely focus on cases of Aspergillus spp.
Advances in the diagnosis of fungal pneumonias
Published in Expert Review of Respiratory Medicine, 2020
Bryan T. Kelly, Kelly M. Pennington, Andrew H. Limper
Blastomyces dermatitidis, the most common cause of Blastomycosis, is a dimorphic fungus endemic to the central and southeastern United States [6]. Clinically, Blastomyces causes infection via direct inhalation, and can then disseminate to a variety of organ systems. The clinical presentation of Blastomycosis is varied, ranging from asymptomatic pulmonary nodules to acute respiratory failure to prostatitis to central nervous system infection increasing the challenge of accurate and timely diagnosis. Current available diagnostic studies include culture, direct visualization, and testing for antigens and antibodies.