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Byline: Preema. Sinha, Durga. Tripathy, Divya. Shelly, Shekhar. Neema Poikilodermatous mycosis fungoides (PMF) is a rare clinical variant of early-stage mycosis fungoides with peculiar histological features and with low risk [...]

ABSTRACT Systemic mycoses can cause a tremendous variety of health problems including digestive difficulties (diarrhea, bloating, discomfort, flatulence, constipation, colitis, etc.), skin problems (rashes, eczema, psoriasis, dry skin patches, intense [...]

The evolution of insecticide resistance in mosquitoes is threatening the effectiveness and sustainability of malaria control programs in various parts of the world. Through their unique mode of action, entomopathogenic fungi provide promising alternatives to chemical control. However, potential interactions between fungal infection and insecticide resistance, such as cross-resistance, have not been investigated. We show that insecticide-resistant Anopheles mosquitoes remain susceptible to infection with the fungus Beauveria bassiana. Four different mosquito strains with high resistance levels against pyrethroids, organochlorines, or carbamates were equally susceptible to B. bassiana infection as their baseline counterparts, showing significantly reduced mosquito survival. Moreover, fungal infection reduced the expression of resistance to the key public health insecticides permethrin and dichlorodiphenyltrichloroethane. Mosquitoes preinfected with B. bassiana or Metarhizium anisopliae showed a significant increase in mortality after insecticide exposure compared with uninfected control mosquitoes. Our results show a high potential utility of fungal biopesticides for complementing existing vector control measures and provide products for use in resistance management strategies. biopesticide | DDT | pyrethoids | resistance management | vector control doi/ 10.1073/pnas.0908530106

To the Editor: Emmonsia spp., dimorphic fungi found worldwide, cause disease mainly among lower order mammals (1). Although emmonsia rarely infect humans, the fungi can cause localized granulomatous pulmonary disease [...]

The common soil fungus Trichoderma (teleomorph Hypocrea, Ascomycota) shows increasing medical importance as an opportunistic human pathogen, particularly in immunocompromised and immunosuppressed patients. Regardless of the disease type and the therapy used, the prognosis for Trichoderma infection is usually poor. Trichoderma longibrachiatum has been identified as the causal agent in the majority of reported Trichoderma mycoses. As T. Iongibrachiatum is very common in environmental samples from all over the world, the relationship between its clinical and wild strains remains unclear. Here we performed a multilocus (ITS1 and 2, tef1, cal1 and chit18-5) phylogenetic analysis of all available clinical isolates (15) and 36 wild-type strains of the fungus including several cultures of its putative teleomorph Hypocrea orientalis. The concordance of gene genealogies recognized T. longibrachiatum and H. orientalis to be different phylogenetic species, which are reproductively isolated from each other. The majority of clinical strains (12) were attributed to T. longibrachiatum but three isolates belonged to H. orientalis, which broadens the phylogenetic span of human opportunists in the genus. Despite their genetic isolation, T. longibrachiatum and H. orientalis were shown to be cosmopolitan sympatric species with no bias towards certain geographical locations. The analysis of haplotype association, incongruence of tree topologies and the split decomposition method supported the conclusion that H. orientalis is sexually recombining whereas strict clonality prevails in T. longibrachiatum. This is a rare case of occurrence of sexual reproduction in opportunistic pathogenic fungi. The discovery of the different reproduction strategies in these two closely related species is medically relevant because it is likely that they would also differ in virulence and/or drug resistance. Genetic identity of environmental and clinical isolates of T. longibrachiatum and H. orientalis suggests the danger of nosocomial infections by Hypocrea/Trichoderma and highlights the need for ecological studies of spore dispersal as source of invasive human mycoses.

Tumor necrosis factor [alpha] (TNF-[alpha]) blockade has emerged as a useful therapy for collagen vascular diseases or graft-vs-host disease. Fungal infections complicating such therapy have been reported sporadically. MEDLINE and [...]

OBJECTIVE. Colonization by Candida spp is a major risk factor for development of fungal sepsis, but little is known about the variables associated with progression to invasive disease in already colonized neonates. We investigated such variables in a large number of colonized preterm neonates in an NICU. SETTING. This study was conducted in the Department of Neonatology and the NICU at Sant'Anna Hospital in Torino, Italy. DESIGN AND PATIENTS A database search of clinical charts and weekly surveillance cultures was used to identify all neonates with birth weights RESULTS. Colonization occurred in 201 infants (32.1% of very low birth weight admitted neonates), and invasive fungal infection occurred in 51 (8.1%) of them, with an overall progression rate of 0.25. At univariate analysis, 10 factors (namely low birth weight, low gestational age, use of third-generation cephalosporins, endotracheal intubation, duration of stay in the NICU, bacterial sepsis, colonization of central venous catheter, of endotracheal tube, of gastric aspirate, or in [greater than or equal to]3 [multiple] sites) were associated with an increased risk of progression, whereas prophylaxis with fluconazole was associated to a decreased risk. After logistic regression, only colonization of central venous catheter and colonization in multiple sites remained significantly associated with invasive fungal infection. Fluconazole prophylaxis remained an independent protective factor. CONCLUSIONS. Central venous catheter colonization and multiple-site colonization are independent risk factors and predictors of progression to fungal sepsis in preterm very low birth weight neonates colonized by Candida spp during their stay in the NICU. Fluconazole prophylaxis is an independent protective factor. These findings can be used to improve the surveillance, prophylaxis, or preemptive measures in neonates at high risk. Key Words very low birth weight, preterm infant, Candida, infection, colonization, progression, INVASIVE FUNGAL INFECTION (IFI) by Candida spp has become an increasing problem over the last 20 years. Fungi are the third most frequent causal agent of late-onset sepsis (LOS) in [...]

Amphibian populations at the Savannah River Site (SRS), South Carolina, USA, have been censused consistently for 35 years, and this provides a time series to examine the causes of population fluctuations. We examined archived museum specimens of 15 anuran species collected at wetlands on the SRS for the presence of the causative agent (Batrachochytrium dendrobatidis) of chytridiomycosis, an emerging disease associated with population declines elsewhere. Infections were present in three out of 137 (2.18%) individuals; the pathogen was detected in two Rana catesbeiana and a single Rana sphenocephala, all collected between 1978 and 1981. Lesions were not consistent with the later stages of fatal chytridiomycosis. Analysis of population trajectories of nine amphibian species over 26 years at SRS showed that four species declined significantly over this period, including R. sphenocephala. However, we demonstrate that these declines are more likely caused by an increase in the number of years with insufficient rainfall and a shortened hydroperiod at the breeding site than by chytrid epidemics. This pattern appears to be linked to a drying trend at SRS through the 1990s, although it is unclear whether this was caused by climate change. This study demonstrates that the presence of B. dendrobatidis in amphibian communities where some species are declining does not always implicate chytrids as a cause of the decline. Like many other emerging pathogens, the outcome of infection can vary among individuals and populations, depending on life history traits, environmental conditions, and virulence factors of the pathogen. Our report also demonstrates the usefulness of archived museum specimens and long-term population monitoring in studying the host--parasite ecology of emerging diseases. Key words: amphibian population declines; Batrachochytrium dendrobatidis; chytridiomycosis; climate change; disease ecology; host--parasite ecology; hydroperiod; Savannah River.

The possible presence of Pneumocystis among healthy adults was examined by detecting Pneumocystis jirovecii--specific DNA in prospectively obtained oropharyngeal wash samples from 50 persons without underlying lung disease or immunosuppression. [...]

The sudden appearance of chytridiomycosis, the cause of amphibian deaths and population declines in several continents, suggests that its etiologic agent, the amphibian chytrid Batrachochytrium dendrobatidis, was introduced into the [...]

* Context.--Allergic mucin, a lamellated collection of inspissated inflammatory debris, has been a hallmark of allergic fungal sinusitis. While its identification is a clue for pathologists to search for fungi, and directs clinicians toward specific therapy and follow-up, recent reports describe cases with allergic mucin but without concomitant fungus. The absence of such organisms in otherwise typical allergic mucin brings into question the role of fungi in allergic fungal sinusitis. Objectives.--To study clinical and pathologic differences between patients with allergic mucin in surgical nasal resection specimens and to elucidate the role of fungus in allergic sinusitis. Design.--Patients with histologic evidence of allergic mucin, with and without fungus, were identified and retrieved from the surgical pathology files of a tertiary-care institution. The patients were separated into 2 groups for analysis, and their clinical and pathologic findings were reviewed and compared. Setting.--Tertiary-care institution. Patients.--All patients who underwent sinus mucosal resection between 1992 and 1998. Results.--Clinical presentation and radiographic findings were similar in both groups. Incidence, age, and gender distribution were similar to data reported previously. However, the amount of allergic mucin was much greater in the group with fungus than in the group without fungus, which to our knowledge is an unreported observation to date. Conclusion.--The presence of allergic mucin is not unique to allergic fungal sinusitis, but rather is the result of a process that could have other etiologies. While perhaps not always causative to the disease, the fungus continues to fuel the process and is likely an entrapped bystander. Allergic fungal sinusitis is more appropriately termed allergic mucinous sinusitis or eosinophilic mucinous rhinosinusitis. (Arch Pathol Lab Med. 2001;125:1442-1447), Acute invasive sinusitis, also referred to by some as fulminant invasive fungal sinusitis, is often seen in immunocompromised patients. Vascular invasion by fungi may result in mycotic thrombosis, and usually [...]

Byline: G. Samonis (1), M. Anatoliotaki (1), H. Apostolakou (1), S. Maraki (1), D. Mavroudis (1), V. Georgoulias (1) Keywords: Key WordsRhodotorula rubra; Fungemia; Neutropenia; Mucositis; Cancer Abstract: A unique case of Rhodotorula rubra transient fungemia in a post-chemotherapy, febrile neutropenic patient with colon cancer, suffering from gastrointestinal mucositis, is described. The fungus was isolated repeatedly from his blood. However, all signs and symptoms of the infection disappeared, without antifungal treatment, as soon as neutropenia and mucositis, both of short duration, resolved. Restoration of the patient's defense mechanisms was adequate for disappearance of the fungus from the patient's blood and full recovery. Author Affiliation: (1) Division of Medicine, The University of Crete, P. O. Box 1393, Heraklion 71110, Crete, Greece Phone (+30/81) 39-2747, Fax -2802, e-mail: georgsec@med.uch.gr, GR Article note: Received: June 7, 2000 * Revision accepted: February 28, 2001

In this issue of the JCI, the observation of the altered pathogenicity of a Cryptococcus neoformans glucosylceramide (GlcCer) mutant shines new light on the initiation of cryptococcal infection. Rittershaus and [...]

The article discusses occurrence, nature, prevalence and the various therapeutic strategies used for the treatment of infections caused by bacterial and fungal biofilms. The biofilm infections are found to lead to increased morbidity and mortality in the patients.