Mycology Unit

South Australia, Australia

Mycology Unit

South Australia, Australia

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Taj-Aldeen S.J.,Mycology Unit | Alkhalf A.,Hamad Medical Corporation | Al Bozom I.,Hamad Medical Corporation | Fothergill A.W.,University of Texas Health Science Center at San Antonio | Sutton D.A.,University of Texas Health Science Center at San Antonio
Medical Mycology | Year: 2010

Cerebral phaeohyphomycosis caused by Rhinocladiella mackenziei (formerly Ramichlo-ridium mackenziei) is extremely rare, and geographically limited to the Middle East. The fungus exclusively targets the brain and infections have a grave prognosis. Eighteen cases have been reported in the literature from 1983 to 2004 with almost 100% mortality. Our patient presented in February 2008 with a brain abscess while receiving chemotherapy for carcinoma of the breast. Diagnosis was by craniotomy and aspiration of the brain abscess. Direct microscopy showed dematiaceous fungal hyphae. R. mackenziei was recovered in culture and this identification was confirmed by molecular analysis. Examination of histopathological sections of tissue from the brain biopsy revealed moniliform hyphae characteristic for phaeohyphomycosis. The patient failed to respond to antifungal therapy with amphotericin B and voriconazole or amphotericin B and posaconazole and finally expired 64 days after diagnosis. In vitro antifungal susceptibility testing showed this isolate to be resistant to amphotericin B while susceptible to itraconazole, voriconazole, and posaconazole. Previously published antifungal susceptibility data indicate that although strains show variable susceptibility to amphotericin B, the organism is generally refractory to treatment with this agent. Similar outcomes are seen with the azole agents used alone or in combination with other drugs. Although no specific risk factors have been identified, the majority of cases have occurred in immunocompromised individuals. R. mackenziei is a highly virulent agent of serious cerebral phaeohyphomycosis, and should be considered in the differential diagnosis of central nervous system disease in the Middle East. © 2010 ISHAM.


Taj-Aldeen S.J.,Mycology Unit | Chandra P.,Hamad Medical Corporation | Denning D.W.,University of Manchester
Mycoses | Year: 2015

Few estimates of fungal disease frequency have been attempted in the Middle East. We have estimated the burden of fungal infections in Qatar. The aim of the study was to compute and determine the burden of serious fungal infections, in an attempt to estimate fungal disease frequency, which has not previously been attempted in this country. Disease statistics were collected from the Microbiology laboratory database and from 2011 WHO statistics. The data are expressed per 100 000 populations. The reported cases of candidaemia rose to 288 with an estimated rate of 15.4/100 000. A real increase in the burden of candidaemia was found over that previously reported (12.9/100 000) for the years 2004-2009. Candida peritonitis was estimated in 8.02 cases/100 000 population. Recurrent (≥4 year-1) vaginal infections affect at least 32 782 women with a rate of 3506/100 000 inhabitants. Severe asthma with fungal sensitisation affected 1486 people, allergic bronchopulmonary aspergillosis 1126 people and chronic pulmonary aspergillosis 176 people. Rhinosinusitis, mucormycosis and Fusarium infection occurred at rates of 2.31, 1.23, 1.86 cases/100 000 respectively. The estimated rate of invasive aspergillosis was very low (0.6/100 000). Low rates of Cryptococcus meningitis and Pneumocystis pneumonia are attributable to low HIV infection rates. In conclusion, fungal infections are increasingly reported, especially candidaemia. Surveillance and guidelines are needed to optimise care and management of common fungal infections. In addition, a fungal registry system needs development for surveillance. © 2015 Blackwell Verlag GmbH.


Taj-Aldeen S.J.,Mycology Unit | Abdulwahab A.,Hamad Medical Corporation | Abdulwahab A.,Weill Cornel Medical College | Kolecka A.,Fungal Biodiversity Center | And 7 more authors.
Medical Mycology | Year: 2014

Eleven uncommon yeast species that are associated with high mortality rates irrespective of antifungal therapy were isolated from 17/187 (201 episodes) pediatric and elderly patients with fungemia from Qatar. The samples were taken over a 6-year period (January 2004-December 2010). Isolated species included Kluyveromyces marxianus, Lodderomyces elongisporus, Lindnera fabianii, Candida dubliniensis, Meyerozyma guilliermondii, Candida intermedia, Pichia kudriavzevii, Yarrowia lipolytica, Clavispora lusitaniae, Candida pararugosa, and Wickerhamomyces anomalus. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry provided correct identifications compared with molecular analysis testing of the same isolates. Low minimal inhibitory concentrations were found when isavuconazole and voriconazole were used for all uncommon yeast species evaluated in this study. Resistance to antifungal drugs was low and remained restricted to a few species. © 2014 The Author.


Taj-Aldeen S.J.,Mycology Unit | Falamarzi A.,Hamad Medical Corporation | AlMuzrkchi A.,Hamad Medical Corporation | Guarro J.,Rovira i Virgili University
Infection | Year: 2012

Rhinosinusitis infection due to Saksenaea vasiformis is extremely rare. The present case describes a rhino-orbital infection in a 21-month-old Chadian immunocompetent male child with a 2-month history of excessive tearing from the right eye, followed by swelling of the right upper and lower eye lids, associated with right facial swelling and dark coloration surrounding the lower eye lid. Coronal computed tomography (CT) scan of the paranasal sinuses showed opacification of the right nasal cavities with extension to the orbit. Non-septate fungal hyphae were diagnosed by tissue sections and a Blankophor P fluorescent stain microscopy. The culture grew zygomycetes, S. vasiformis that failed to sporulate on Sabouraud dextrose agar, the organism was sporulated after 1 week on Czapek agar medium, and produced flask-shaped brown pigmented sporangium with lateral rhizoids and hemispherical columella filled with spores. The patient underwent a right functional endoscopic sinus surgery, where debridement of both right maxillary and ethmoid sinuses was done. Treatment with amphotericin B lipid complex was started and continued for 41 days. The patient was clinically doing better with decreased eye and facial swelling, and his erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were decreased to normal values. The patient continued with treatment on posaconazole after his discharge, and his condition resolved without further sequelae. Rhinosinusitis due to mucormycosis should be considered in any patient, even in young children, presenting with progressive rhinosinusitis infection, whether immunocompromised or not. Early diagnosis may lead to a successful treatment and good prognosis. © Springer-Verlag 2012.


PubMed | National University of Health Sciences, Mycology Unit and Hamad Medical Corporation
Type: | Journal: Mycoses | Year: 2015

Few estimates of fungal disease frequency have been attempted in the Middle East. We have estimated the burden of fungal infections in Qatar. The aim of the study was to compute and determine the burden of serious fungal infections, in an attempt to estimate fungal disease frequency, which has not previously been attempted in this country. Disease statistics were collected from the Microbiology laboratory database and from 2011 WHO statistics. The data are expressed per 100,000 populations. The reported cases of candidaemia rose to 288 with an estimated rate of 15.4/100,000. A real increase in the burden of candidaemia was found over that previously reported (12.9/100,000) for the years 2004-2009. Candida peritonitis was estimated in 8.02 cases/100,000 population. Recurrent (4 year(-1) ) vaginal infections affect at least 32,782 women with a rate of 3506/100,000 inhabitants. Severe asthma with fungal sensitisation affected 1486 people, allergic bronchopulmonary aspergillosis 1126 people and chronic pulmonary aspergillosis 176 people. Rhinosinusitis, mucormycosis and Fusarium infection occurred at rates of 2.31, 1.23, 1.86 cases/100,000 respectively. The estimated rate of invasive aspergillosis was very low (0.6/100,000). Low rates of Cryptococcus meningitis and Pneumocystis pneumonia are attributable to low HIV infection rates. In conclusion, fungal infections are increasingly reported, especially candidaemia. Surveillance and guidelines are needed to optimise care and management of common fungal infections. In addition, a fungal registry system needs development for surveillance.


Macesic N.,Royal Melbourne Hospital | Fleming S.,Royal Melbourne Hospital | Kidd S.,Mycology Unit | Madigan V.,Royal Melbourne Hospital | And 7 more authors.
Transplant Infectious Disease | Year: 2014

Prototheca species are achlorophyllus algae. Prototheca wickerhamii and Prototheca zopfii cause human disease. In immunocompetent individuals, they cause soft tissue infections and olecranon bursitis, but in transplant recipients, these organisms can cause disseminated disease. We report a fatal case of disseminated P. zopfii infection in an hematopoietic stem cell transplant (HSCT) recipient with bloodstream infection and involvement of multiple soft tissue sites. We review all previous cases of protothecosis in HSCT reported in the literature. Protothecosis is uncommon after HSCT, but has a disseminated presentation that is frequently fatal. It is commonly misidentified as a yeast. Tumor necrosis factor-alpha inhibitors and contamination of central venous catheters may contribute to development of protothecosis. Optimal treatment approaches are yet to be defined. New agents such as miltefosine may be possible future therapies. © 2014 John Wiley & Sons A/S.


PubMed | Rovira i Virgili University, Mycology Unit, Fungal Biodiversity Center and Cerrahpasa Medical Faculty
Type: Journal Article | Journal: Revista iberoamericana de micologia | Year: 2016

Cladophialophora bantiana is a melanised mold with a pronounced tropism for the central nervous system, almost exclusively causing human brain abscesses.We describe a case of cerebral infection by this fungus in an otherwise healthy 28-year-old coal-miner. Environmental occurrence, route of entry, and incubation period of this fungus are unknown, but our case is informative in that the first symptoms occurred about eight weeks after known traumatic inoculation. Lesions were compatible with tuberculous granulomas, and the patient initially received antitubercular treatment. Melanised fungal cells were seen in a brain biopsy and abscess materials. Therapy was switched from empirical antitubercular treatment to amphotericin B (0.5mg/kg/d), but was changed to voriconazole 200mg/d, i.v. on the basis of antifungal susceptibility test results. The patient responded clinically, and gradually improved. The isolate was identified by sequencing of the Internal Transcribed Spacer domain of rDNA.Given the non-specific clinical manifestations of C. bantiana cerebral abscesses, clinicians and laboratory workers should suspect infections caused by C. bantiana, particularly in immunocompromised patients with a trauma history.


PubMed | University of Amsterdam, Rovira i Virgili University, Mycology Unit and Cerrahpasa Medical Faculty
Type: | Journal: Medical mycology | Year: 2016

Cladophialophora bantiana is a phaeoid fungus that only rarely has been isolated from sources other than the human brain. It has a particular tropism for the central nervous system (CNS). We have integrated and updated large-scale data related to several aspects of C. Bantiana and reviewed all the available reports on its cerebral infections, focusing on their geographical distribution, infection routes, immune status of infected individuals, type and location of infections, clinical manifestations and treatment and outcome, briefly looking over the spectrum of other disease entities associated with C. bantiana, that is, extra-cerebral and animal infections and on the environmental sources of this fungus. Among the agents of phaeohyphomycosis, a term used to describe an infection caused by a dark pigmented fungus, C. bantiana has some significant specific features. A total of 120 case reports were identified with a significantly higher percentage of healthy subjects than immune-debilitated patients (58.3%vs. 41.7%). Infections due to C. bantiana occur worldwide. The main clinical manifestations are brain abscess (97.5%), coinfection of brain tissue and meninges (14.2%) and meningitis alone (2.5%). Among immunocompetent patients, cerebral infection occurred in the absence of pulmonary lesions. The mortality rate is 65.0% regardless of the patients immune status. The therapeutic options used include surgery or antifungals alone, and the combination of both, in most cases the fatal outcome being rapid after admission. Since the fungus is a true pathogen, laboratory workers should be made aware that BioSafety Level-3 precautions might be necessary.


PubMed | UPSP 5304, Mycology Unit and Nutrition and Endocrinology Unit
Type: Journal Article | Journal: Veterinary dermatology | Year: 2016

The diagnosis of canine atopic dermatitis (CAD) remains challenging due to the lack of a simple biomarker or metabolic profile. In human medicine, Fourier transform infrared spectroscopy (FTIR) is an analytical technique used for several diseases. It requires a small amount of sample and allows the identification of structural moieties of biomolecules on the basis of their infrared absorption, with limited sample pretreatment.The aim of the study was to evaluate the diagnostic value of FTIR.Three groups were tested: 21 dogs with non food-induced CAD (NFICAD), 16 dogs with inflammatory conditions of various origins but without allergic dermatoses (OD) and 10 healthy dogs (H).Peripheral blood was collected and spectra were acquired with a FTIR spectrophotometer. A principal component analysis (PCA) was performed on the full wavenumber spectra (4000-600/cm), followed by a Fisher discriminant analysis (DA) to assess the differences between the three groups.The PCA followed by the DA of whole spectra showed significant differences between the three groups. These results suggest that by using the FTIR method, dogs with NFICAD can be differentiated from healthy dogs and dogs with nonallergic inflammation. There was no overlap between the spectral data of the three groups indicating that NFICAD dogs were correctly segregated from the H and OD groups.A study on a larger cohort including common pruritic skin diseases is necessary to confirm these initial results and the relevance of this diagnostic technique.


PubMed | Father Muller Medical College and Mycology Unit
Type: Journal Article | Journal: Mycopathologia | Year: 2015

We report a case of subcutaneous fungal abscess over the great toe caused by a keratinophilic fungus, an unknown Chrysosporium sp., in a 60-year-old diabetic female who was treated successfully with oral fluconazole. The fungus was isolated from aspirated pus, and septate hyphae were seen in fine needle aspiration cytology. Ovoid- to club-shaped hyaline one-celled conidia (aleuriconidia) with broad truncated bases were seen, and sequencing of ITS1-5.8S-ITS2 rDNA revealed belonging to the order Onygenales and most closely related to Chrysosporium spp. isolated from a fowl. Of the 65 species within the genus Chrysosporium, very few have been reported as pathogenic.

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