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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

Dea Garcia-HermosoComments to Author , Samia Hamane, Arnaud Fekkar, Arnaud Jabet, Blandine Denis, Martin Siguier, Guy Galeazzi, Elie Haddad, Sophie Brun, Valérie Vidal, Gilles Nevez, Rozenn Le Berre, Maud Gits-Muselli, Fanny Lanternier, and Stéphane Bretagne
Author affiliations: Institut Pasteur, Paris, France (D. Garcia-Hermoso, F. Lanternier, S. Bretagne); Hôpitaux Lariboisière–Saint-Louis-Fernand Widal, Assistance Publique–Hôpitaux de Paris, Paris (S. Hamane, A. Jabet, B. Denis, M. Siguier, M. Gits-Muselli, S. Bretagne); Groupe Hospitalier Pitié–Salpêtrière, Assistance Publique–Hôpitaux de Paris, Sorbonne Université, Paris (A. Fekkar); Hôpital Max Fourestier, Nanterre, France (G. Galeazzi); Centre Hospitalier Universitaire Hôtel-Dieu de France, Université de Saint-Joseph, Beirut, Lebanon (E. Haddad); Hôpital Avicenne, Assistance Publique–Hôpitaux de Paris, Bobigny, France (S. Brun, V. Vidal); Hôpital La Cavale Blanche, Centre Hospitalier Universitaire de Brest, Brest, France (G. Nevez, R. Le Berre); Université Paris 13, Paris (S. Brun); Université de Paris, Paris (M. Gits-Muselli, F. Lanternier, S. Bretagne)

Main Article

Table 2

Clinical and laboratory characteristics of invasive infections with Nannizziopsis obscura as previously reported in the literature*

Year of diagnosis Sex/age, y Underlying risk factors Country of birth/time since last travel in Africa Clinical, radiologic, and biologic findings Direct examination Serum β-D-glucan (Fungitell) Suspected identification at diagnosis Treatment (duration) Outcome Ref
Before 1982 (reported in 1984) M/24 HIV, osteomyelitis Africa/7 y Tibia (abscess) Septate hyphae and budding yeasts Not done Geotrichum sp. and then Chrysosporium sp. Amphotericin B (4 mo) Persistent lytic area in the distal tibia after 2 y (3)
2005 M/38 HIV Nigeria (living in Germany)/NA Brain (abscess, needle aspiration); lung (nodules) Not available Not done Chrysosporium anamorph of Nannizziopsis vriesii Voriconazole Recovery without sequelae after 4 mo (4)
2015 F/63 T-cell prolymphocytic leukemia (2014) France/6 mo (Senegal) Blood (blood culture, positive PCR on CSF, ascites fluid) Septate hyphae, arthroconidia Not done N. obscura Not treated Dead before diagnosis (6)
2015 M/34 Renal transplant (2008) Gambia/3 mo Back (paraspinal abscesses); lymph nodes (needle aspiration) Aleurioconidia and arthroconidia in chains Not done N. obscura Posaconazole Recovery after 10 mo of azole therapy (7)
2017 F/52 AIDS Mali/resident Brain (abscess), lung (nodule), β-D-glucan+ Not done 953 pg/mL N. obscura LAMB (1 mo), craniotomy, then voriconazole Recovery but neurologic sequelae after 2 mo (6)

*CSF, cerebrospinal fluid; LAMB, liposomal amphotericin B; Ref, reference.

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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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