Abstract
BackgroundPythium, soil-borne plant pathogens, are in the class Oomycetes. They are not true fungi, but are related to diatom and algae. There are two human pathogens including P. insidiosum and P. aphanidermatum. To date, only one case of pythiosis caused by P. aphanidermatum has been reported. We present herein the first case of P. aphanidermatum vascular pythiosis in Asia.Case presentationA 47-year-old Thai woman, living in North Thailand, with ß thalassemia/hemoglobin E presented with acute recurrent arterial insufficiency of both legs. Emergent embolectomy with clot removal was performed. The pathology of the clot exhibited noncaseous granulomatous inflammation with many fungal hyphal elements. PCR identified P. aphanidermatum with 100% identity. Final diagnosis is vascular pythiosis. Unfortunately, the patient eventually expired after treatment with itraconazole, terbinafine, azithromycin, and doxycycline.ConclusionsTo date, only one case of pythiosis caused by P. aphanidermatum has been reported. We present herein the first case of P. aphanidermatum vascular pythiosis in Asia.
Highlights
BackgroundPythium are soil-borne plant pathogens in swampy areas in Thailand and many tropical and subtropical countries [1]
Pythium, soil-borne plant pathogens, are in the class Oomycetes
To date, only one case of pythiosis caused by P. aphanidermatum has been reported
Summary
Pythium are soil-borne plant pathogens in swampy areas in Thailand and many tropical and subtropical countries [1]. Case presentation A 47-year-old Thai woman, living at Maesot, Tak, North Thailand, with ß thalassemia/hemoglobin E, was referred from a provincial hospital for further investigations regarding acute arterial insufficiency of both legs. Emergent embolectomy with clot removal at left common iliac artery was performed. The pathology of the clot exhibited noncaseous granulomatous inflammation with many fungal hyphal elements (Fig. 1A), and the patient was referred to King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand, for further investigations. 2 weeks after treatment with itraconazole, terbinafine, azithromycin, and doxycycline as well as an iron chelator, deferoxamine
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