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Biomedical subjects

J Gené

Publications and source records attributed to J Gené.

At least 19 recordsLinked to original sources
PubMed2003

Molecular typing of clinical and environmental isolates of Scedosporium prolificans by inter-simple-sequence-repeat polymerase chain reaction.

Invasive infections by Scedosporium prolificans have increased alarmingly in recent years, mainly in immunosuppressed patients. The epidemiology, pathogenesis and the natural habitat of this pathogen are practically unknown. Isolates of S. prolificans were distinguished from one another by inter-simple-sequence-repeat (ISSR) fingerprinting, a technique based on the high degree of polymorphism of the multisatellite genetic markers used. This technique was found useful for typing 84 isolates of S. prolificans from different countries and sources. The assemblage of S. prolificans isolates tested was extremely diverse, with 35 genotypes present. Several patients were found to have been infected or colonized by more than one strain. Overall, this technique facilitates the epidemiological study of S. prolificans infection.

Australia↗
PubMed2001

Cutaneous infection caused by Aspergillus ustus, an emerging opportunistic fungus in immunosuppressed patients.

We report a case of primary cutaneous infection by the emerging fungus Aspergillus ustus in an immunosuppressed patient after a domestic accident. The patient failed to respond to itraconazole and died before receiving a new treatment with amphotericin B. There have been eight other cases reported since 1973, and only two patients survived the infection. In vitro susceptibility testing of seven antifungal drugs showed that terbinafine and the new azole derivative UR-9825 were the most active against this fungus.

Aged↗
PubMed2001

Phaeohyphomycotic cyst caused by Colletotrichum crassipes.

A case of phaeohyphomycosis is reported in a male renal transplant recipient with a nodular lesion in the right leg who was treated with immunosuppressing drugs. The lesion consisted of a purulent cyst with thick walls. The cyst was excised surgically, and the patient did not receive any antifungal therapy. One year later he remains well. Histological study of the lesion showed a granulomatous reaction of epithelioid and multinucleate giant cells, with a central area of necrosis and pus. Fontana-Masson staining demonstrated the presence of pigmented hyphal elements. The fungus Colletotrichum crassipes was grown in different cultures from the cyst. The in vitro inhibitory activities of eight antifungal drugs against the isolate were tested. Clotrimazole and UR-9825 were the most active drugs. This case represents the first known reported infection caused by this rare species.

Adult↗
PubMed2000

Emerging pathogens.

The ever increasing numbers of immunosuppressed individuals has led to a significant increase in the incidence of opportunistic infections, particularly those caused by fungi. The epidemiology of infections caused by the common fungal pathogens such as Candida albicans, Cryptococcus neoformans and Aspergillus fumigatus has been well documented. However, in addition to these, a number of species which have previously been unrecognized (e.g., C. dubliniensis) or have previously been assumed to be non-pathogenic (e.g., Saccharomyces cerevisiae, Scedosporium spp. and Fusarium spp.) have emerged as agents of human disease. Since these species have only been identified recently as human pathogens, their role in disease is poorly understood. In most cases, identification of these species is problematic and therefore their epidemiology has yet to be elucidated adequately. In addition, several of these species fail to respond to conventional antifungal therapies. In this article, we describe the emergence of two separate yeast species (C. dubliniensis and S. cerevisiae) and two separate groups of moulds (Scedosporium prolificans and Fusarium spp.), as human pathogens. It is apparent from what we already know, that much work has yet to be performed before we have a clear understanding of how these species cause disease and most importantly how they can be controlled.

Candida↗
PubMed2000

Fungemia due to Fusarium sacchari in an immunosuppressed patient.

The fungus Fusarium sacchari was isolated repeatedly from the blood of an immunosuppressed host. The infection was treated successfully with a small dose of amphotericin B. The strain was resistant to this antifungal in vitro. MICs and minimum fungicidal concentrations of six antifungals for the clinical isolate are provided. To our knowledge, this is the first report involving this fungus in a case of fungemia.

Adult↗
PubMed2000

Phaeoisaria clematidis as a cause of keratomycosis.

We report the first case of human infection by Phaeoisaria clematidis. This fungus caused a corneal ulcer in a Brazilian man who had previously suffered an eye injury. Diagnosis was established by positive direct examination and repeated cultures. The isolate was clearly resistant in vitro to the six antifungal agents tested.

Adrenal Cortex Hormones↗
PubMed2000

Mixed infection caused by two species of Fusarium in a human immunodeficiency virus-positive patient.

We report on a case of mixed infection caused by two species of Fusarium in a human immunodeficiency virus-positive patient with lymphoma who was neutropenic due to chemotherapy. The patient showed the typical signs of a disseminated fusarial infection, with Fusarium solani isolated from skin lesions and F. verticillioides isolated from blood. The report discusses how difficult it is to make an accurate diagnosis when an immunosuppressed patient is infected with more than one fungal species, especially when the species are morphologically very similar.

AIDS-Related Opportunistic Infections↗
PubMed1999

Case of onychomycosis caused by Microsporum racemosum.

We report the case of a Spanish 60-year-old female who presented in 1997 with onychomycosis of the left thumbnail following an injury caused by a fresh fish bone. Microsporum racemosum was repeatedly cultured from nail scrapings, and its identity was confirmed by sequencing the isolate's ITS1/ITS2 and 5.8S rRNA regions. The patient was successfully treated with itraconazole, which was administered for 12 weeks. This represents the first case of onychomycosis due to M. racemosum and the first time that this species has been isolated from a human in Europe.

DNA, Fungal↗
PubMed1999

Fatal case of Trichoderma harzianum infection in a renal transplant recipient.

We describe the second known case of human infection by Trichoderma harzianum. A disseminated fungal infection was detected in the postmortem examination of a renal transplant recipient and confirmed in culture. The only other reported infection by this fungus caused peritonitis in a diabetic patient. The in vitro antifungal susceptibilities of the clinical strain and three other strains of Trichoderma species to six antifungal drugs are provided. This case illustrates the widening spectrum of opportunistic Trichoderma spp. in immunocompromised patients and emphasizes the problems in diagnosing invasive fungal diseases.

Aged↗
PubMed1999

Mycotic keratitis due to Curvularia senegalensis and in vitro antifungal susceptibilities of Curvularia spp.

A case of mycotic keratitis due to Curvularia senegalensis is reported. This case represents the third known reported infection caused by this rare species. Fungal hyphae were detected in corneal scrapings, and repeated cultures were positive for this fungi. The patient was presumed cured after a corneal transplant and treatment with itraconazole, but the infection recurred and the patient is waiting for a keratoplasty. The in vitro antifungal susceptibilities of the case strain and another 24 strains belonging to seven species of Curvularia were tested for six antifungal agents. With the exception of flucytosine, and occasionally fluconazole, the other drugs assayed (amphotericin B, miconazole, itraconazole, and ketoconazole) were highly effective in vitro.

Adult↗
PubMed1999

Phialemonium fungemia: two documented nosocomial cases.

Two fungal isolates recovered from the blood of two immunosuppressed patients are described as Phialemonium curvatum. One patient died, while the other, who was infected with Exophiala jeanselmei at the same time, survived after successful treatment with itraconazole. Analysis of internal transcribed spacer sequences demonstrated that the isolates belonged to the same strain and that the source of infection was probably a catheter. The taxonomic position of P. curvatum is discussed, and Phialemonium dimorphosporum is considered a synonym. The in vitro inhibitory activities of six antifungal agents (amphotericin B, itraconazole, ketaconazole, miconazole, flucytosine, and fluconazole) were determined against seven isolates of Phialemonium. Except for flucytosine, all of them were remarkably effective. Phialemonium should be added to the list of potential causes of nosocomial fungemia in cancer patients.

Adult↗
PubMed1998

Subcutaneous hyalohyphomycosis caused by Colletotrichum gloeosporioides.

The coelomycete Colletotrichum gloeosporioides was isolated in pure culture from subcutaneous nodules of the left forearm and elbow of a farmer after traumatic injury. To our knowledge, we report the first case involving this fungus as an etiological agent of subcutaneous infection. The in vitro inhibitory activities of amphotericin B, itraconazole, ketoconazole, miconazole, flucytosine, and fluconazole were studied.

Accidents, Occupational↗
PubMed1997

Acremonium species: new emerging fungal opportunists--in vitro antifungal susceptibilities and review.

We provide an overview of opportunistic fungal infections caused by Acremonium (Cephalosporium) species and discuss the classification of these species as well as the diagnosis and treatment of acremonium infections. We used a microdilution broth method to compare in vitro susceptibilities and minimum inhibitory concentrations and minimum fungicidal concentrations of amphotericin B, miconazole, itraconazole, 5-fluorocytosine, fluconazole, and ketoconazole for 33 clinical and environmental isolates of Acremonium. In general, the isolates tested displayed little susceptibility to the antifungals tested. Fluconazole and 5-fluorocytosine were ineffective in all cases. The efficacy of the remaining drugs was dependent on the strain. Amphotericin B showed the best results.

Acremonium↗
PubMed1997

In-vitro antifungal susceptibility of clinical and environmental Fusarium spp. strains.

The MICs of amphotericin B, miconazole, ketoconazole, flucytosine, itraconazole and fluconazole for 19 isolates of Fusarium oxysporum, 16 Fusarium solani, seven Fusarium verticilliodes, four Fusarium proliferatum, four Fusarium dimerum, three Fusarium equiseti, and one each of the following species: Fusarium graminearum, Fusarium chlamydosporum, Fusarium semitectum, Fusarium avenaceum and Fusarium subglutinans were determined by a broth microdilution method. Thirty-eight of these isolates were of clinical origin and 20 from environmental sources. In general, Fusarium spp. strains showed resistance to all the antifungals tested. However, the most active agent was amphotericin B. Fluconazole and flucytosine were not active against any of the isolates tested. A correlation study of in-vitro testing with in-vivo outcome of amphotericin B of the cases of disseminated fusarium infections published is reported.

Antifungal Agents↗
PubMed1996

Molecular characterization, relatedness and antifungal susceptibility of the basidiomycetous Hormographiella species and Coprinus cinereus from clinical and environmental sources.

Hormographiella-like strains, isolated from different natural substrates and producing sclerotia and occasionally basidiomata of Coprinus cinereus, were compared morphologically and using molecular techniques with clinical strains of Hormographiella aspergillata and H. verticillata. Analysis of restriction fragment length polymorphisms of ribosomal and mitochondrial-like DNA confirmed interspecific differences between H. aspergillata and H. verticillata, supporting the morphological data, and helped demonstrate that H. aspergillata is the anamorph of C. cinereus. The latter was confirmed also by crossing tests. The analysis of the mtDNA restriction profiles revealed intraspecific variability in C. cinereus, which allowed differentiation of clinical and environmental strains. Due to the implication of C. cinereus and Hormographiella in human opportunistic infections, the antifungal susceptibility test is included. Results show that all strains were susceptible to miconazole, itraconazole and ketoconazole but not to flucytosine and fluconazol. Susceptibility against amphotericin B was variable; while H. verticillata was susceptible, four out of seven C. cinereus strains tested were resistant.

Antifungal Agents↗