Volume 26, Number 9—September 2020
CME ACTIVITY - Synopsis
Invasive Infections with Nannizziopsis obscura Species Complex in 9 Patients from West Africa, France, 2004–20201
Table 1
Patient no./ CNRMA strain no. | Year of diagnosis | Patient age, y/sex | Underlying risk factors | Country of birth/time since last travel in Africa | Clinical, radiologic, and biological findings | Direct examination | Serum β-D-glucan (Fungitell), pg/mL | Suspected identification at diagnosis | Treatment (duration) | Outcome |
---|---|---|---|---|---|---|---|---|---|---|
P1/4.1162 | 2004 | 49/M | AIDS | Mali/2 mo | Liver abscess† | Hyphae and arthroconidia | Not done | Trichosporon sp., Chrysosporium sp. | LAMB (unknown) | Lost to follow-up |
P2/9.1232 | 2009 | 50/M | Heart transplant 2 mo earlier | Mali/NA | Fungemia,† cutaneous ulcers | Not done | Not done | Chrysosporium sp. | None | Death 2 d after diagnosis |
P3/17.78 | 2016 | 58/F | Diabetes, Renal transplant (2017) | Mali/NA | Disseminated subcutaneous abscess† (legs, back) and pulmonary nodules | Septate, vesiculous mycelia, clavate sessile conidia | >500 | Trichophyton rubrum | Posaconazole | No relapse after 1 y |
P4/17.507 | 2017 | 62/M | Renal transplant (2009) | Guinea/1 y | Suppurated lesions (right ankle)† and lung micronodules, β-D-glucan+ | Hyphae and arthroconidia | >500 | Trichosporon sp. | Posaconazole | No relapse after 2 y |
P5/18.682 | 2018 | 69/F | Mantle cell lymphoma (2017) | Guinea-Bissau/2 y | Pulmonary nodules, bronchial ulcerations and hyperchromic skin nodules,† β-D-glucan+ | Hyphae and arthroconidia | >500 | Trichophyton rubrum | Terbinafine, then voriconazole and LAMB | Death 6 wks after skin biopsy |
P6/18.740 | 2018 | 28/F | Not known | Guinea/2 y | Mediastin (deep abscess)† | Hyphae | 306 | Trichophyton rubrum | Posaconazole, then voriconazole | Lost to follow-up |
P7/19.38 | 2018 | 38/M | Renal transplant (2015) | Mali/1 y | Brain abscess† | Septate hyphae | >500 | Candida sp. | LAMB and fluconazole, then LAMB and voriconazole | Alive 12 mo later |
P8/19.607 | 2019 | 79/M | Renal transplant (2014) | Mali/3 y | Subcutaneous abscess (hand)† and pulmonary nodules, β-D-glucan+ | Septate, vesiculous mycelia, clavate sessile conidia | 255 | Trichophyton rubrum | Itraconazole ongoing | Alive 4 mo later |
P9/20.123 | 2019 | 65/M | Renal transplant (2018) | Mali/6 mo | Subcutaneous abscess (clavicle) and fistula with pus | Hyphae | >520 | Nannizziopsis sp. | Voriconazole (ongoing) | Alive |
*CNRMA, Centre National de Référence Mycoses Invasives et Antifongiques; LAMB, liposomal amphotericin B.
†Original site of isolation (in cases when multiple sites were sampled).
1Preliminary results of this study were presented at the International Society for Human and Animal Mycology, June 30–July 4, 2018, Amsterdam, the Netherlands (poster 174, Medical Mycology 56, Supplement 2).
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Page updated: August 14, 2020
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