Causative Fungus Research Articles

Rare Case of Subcutaneous Phaeohyphomycosis Caused by Exophiala jeanselmei

Abstract Introduction/Objective Phaeohyphomycosis is a neglected tropical infection caused by dematiaceous fungi containing melanin in their cell wall. Currently, the prevalence of phaeohyphomycosis is very low in the United States compared to other mycotic agents. Trauma often precedes phaeohyphomycosis, and there are a limited number of cases associated with healthcare settings. This case report describes a nosocomial phaeohyphomycosis caused by Exophiala jeanselmei. Methods/Case Report A 60-year-old male with multiple myeloma, on immunosuppressive therapy, presented with a large fluctuant mass on the dorsum of his right hand. The mass had developed 6 months ago as a hematoma following a blown vein during a blood draw. Despite treatment with antibiotics, the mass continued to grow. The patient underwent surgical excision of the lesion, and the purulent aspirate was sent to the microbiology lab. Aerobic, anaerobic, mycobacterial, and fungal cultures, along with Gram and AFB stains, were performed. Direct microscopy of the aspirate revealed numerous leukocytes and few yeast cells. No sclerotic bodies were observed. Fungal growth with black pigmentation was observed during the second week of incubation. Colonies initially appeared smooth black and mucoid, later transforming into raised dome-shaped structures with a suede-like texture. Microscopic analysis revealed budding yeast cells and subglobose to broadly ellipsoidal germinating cells, which developed into short torulose hyphae before gradually transforming into unswollen hyphae. The isolate was further identified through D2 rDNA sequencing, revealing a 100% match for Exophiala jeanselmei. The patient was prescribed a one-month course of itraconazole treatment. The patient is progressing well during follow-up. Results (if a Case Study enter NA) NA Conclusion This case emphasizes the need for heightened clinical awareness in diagnosing phaeohyphomycosis, particularly in healthcare environments. Unique traumatic events like venepuncture should raise suspicion of phaeohyphomycosis. Culture and molecular diagnostics play a crucial role in confirming fungal causes and guiding treatment, leading to better patient outcomes.

Fungal Shoulder Periprosthetic Infections: A Systematic Review.

Background: Data regarding fungal PJIs of the shoulder are scarce. The present systematic review aims to identify and evaluate all published shoulder fungal PJIs in an effort to better understand the diagnostic and therapeutic approach to these infections. Methods: A systematic review according to the PRISMA guidelines was conducted, locating all shoulder fungal PJIs. The initial search located 1435 articles. Data were collected on demographics, the causative fungus, antifungal treatment (AFT), surgical interventions, and infection outcomes. Results: After screening and implementation of the inclusion criteria, a total of 10 articles, including 10 cases, were eligible. The sample's mean age was 62.44 years. Diabetes mellitus was the most common comorbidity (30%), while 70% were immunocompromised. Candida spp. was the most common causative fungus (nine cases; 90%), while all cases were confirmed with cultures. In three cases (30%), there was bacterial co-infection. The mean duration of antifungal treatment (AFT) was 8.4 weeks, while the preferred agent was fluconazole (60% of cases), followed by amphotericin B (30%). Most cases (50%) underwent resection arthroplasty as part of the treatment, while two-stage revision arthroplasty was performed in 30%. Infection's eradication was reported in 90% of the studied cases. Conclusions: The diagnosis and management of fungal periprosthetic shoulder infections are particularly challenging and require a multidisciplinary approach. The combination of antifungal therapy and tailored surgical strategies is crucial, but further research is needed to refine treatment protocols and address the unique considerations in shoulder PJIs.

Emerging Fungal Infections of the Central Nervous System in the Past Decade: A Literature Review.

Invasive fungal infections affecting the central nervous system (CNS) are a major health concern worldwide associated with high mortality rates. Their increased incidence is largely due to an increase in the vulnerable immunocompromised population, changing environmental factors, and development of more accurate diagnostic methods. The aim of this article is to identify fungal causes of CNS infections that are recently emerging or have the potential to become emerging pathogens in the near future, as well as their clinical characteristics, including: Candida auris, Trichosporon spp., Blastomyces spp., Sporothrix spp., Talaromyces marneffei, Lomentospora prolificans, and Scedosporium spp. A review of the literature in PubMed in the last ten years was conducted to identify central nervous system infections caused by each of these fungi. The review identified 10 cases caused by C. auris, 5 cases by Trichosporon spp., 82 cases by Blastomyces spp., 36 cases by Sporothrix spp., 21 cases by T. marneffei, 22 cases by Lomentospora prolificans, and 42 cases by Scedosporium spp. The exact burden of these diseases remains difficult to ascertain, but their apparent rise underscores the urgent need for improved diagnostic, treatment, and management strategies against CNS fungal pathogens to improve outcomes against these life-threatening infections.

Prevalence and Risk Factors of Tinea Capitis Among Primary School Children in the Grand Lomé Region (Togo), 2021: A Cross-Sectional and Case-Control Study Approach.

Tinea capitis is an infectious dermatosis frequent in children, causative fungi variable over time and space. The risk factors associated with this disease are still poorly understood. The objective of this study was to estimate the prevalence of tinea capitis among schoolchildren in Lomé (Togo), identify the fungal species involved and assess the associated risk factors. It was a cross-sectional and case-control study conducted in primary schools in Lomé from November 2020 to April 2021. All pupils presenting tinea capitis suspected lesions have been sampled, and the scraping and hair were examined by direct microscopy in KOH solution and cultured in Sabouraud dextrose agar with chloramphenicol and cycloheximide. Positive children were matched by age and sex with those without symptoms for case-control study. Out of the 15,087 pupils enrolled, 465 had positive cultures for dermatophytes, corresponding to the tinea capitis prevalence of 3.08% (95% CI [2.59-3.57]). Trichophyton mentagrophytes (81.86%) and Trichophyton soudanense (13.12%) were the majors isolated dermatophytes. The risk factors were mostly living in households with domestic animals, showering less than twice a day, having a history of ringworm, having similar lesions in the same household and sharing personal hygiene items. This study highlights the low prevalence of tinea capitis in schoolchildren in Lomé (Togo), the causative species dominated by T. mentagrophytes and emphasises the importance of environmental and behavioural factors in the mycosis transmission. Implementing preventive measures addressing the identified factors could help to reduce the prevalence of this disease.

Evaluation of garlic extracts antifungal potential against causative fungi of dermatomycosis in Chile

BACKGROUND: Several studies on garlic have shown that due to its bioactive components it exhibits antimicrobial properties. The most prevalent dermatomycoses are those caused by dermatophytes and yeasts of the genus Candida. In recent years, an increase in recurrent and recalcitrant cases has been reported due to strains of dermatophytes resistant to terbinafine, a considered first-line antifungal. OBJECTIVE: The objective of this work was to determine the in-vitro antifungal effect of extracts from Chinese garlic (fresh variety) and Chilote garlic (fresh and black varieties), against the two main fungi that cause superficial mycoses: Trichophyton rubrum and Candida albicans. METHODS: Fresh garlic extracts were prepared with a hydroalcoholic method with subsequent freeze-drying. Decreasing concentrations of each extract were tested. RESULTS: Both fresh Chilote garlic and its black variety showed an antifungal effectiveness at different concentrations on both analyzed fungal agents, while white garlic of Chinese origin did not show effectiveness against C. albicans at any concentration tested. CONCLUSIONS: Black garlic, compared to fresh garlic, does not release a strong characteristic odor or flavor, which would open a point of interest as a natural alternative to the antifungals currently used. RESUMEN INTRODUCCIÓN: Numerosos estudios sobre el ajo han demostrado que, debido a sus componentes bioactivos exhibe propiedades antimicrobianas. Las dermatomicosis de mayor prevalencia son las producidas por dermatofitos y por levaduras del género Candida. En los últimos años, se ha reportado un aumento en casos recurrentes y recalcitrantes dado por cepas de dermatofitos resistentes a terbinafina, antifúngico considerado de primera línea. OBJETIVO: El objetivo del presente trabajo fue determinar el efecto antifúngico in-vitro de extractos provenientes de ajo chino (variedad fresca) y ajo chilote (variedades fresca y negra), frente a los dos principales hongos causantes de micosis superficiales: Trichophyton rubrum y Candida albicans. MÉTODOS: Los extractos de ajo fresco se realizaron con un método hidroalcohólico con posterior liofilización. Se testearon concentraciones decrecientes de cada extracto. RESULTADOS: Se observó que tanto el ajo chilote fresco como su variedad negra, poseen efectividad antifúngica para ambos agentes analizados, pero en diferentes concentraciones, mientras que el ajo blanco de origen chino no mostró efectividad frente a C. albicans en ninguna concentración testeada. CONCLUSIÓN: El ajo negro en comparación al ajo fresco, no libera un fuerte olor ni sabor característicos, lo que abriría un punto de interés como alternativa natural a los antifúngicos actualmente empleados.

Ex vivo host transcriptomics during Cryptococcus neoformans, Cryptococcus gattii, and Candida albicans infection of PBMCs from South African volunteers.

Cryptococcus neoformans, Cryptococcus gattii and Candida albicans are opportunistic fungal pathogens associated with infections in immunocompromised hosts. Cryptococcal meningitis (CM) is the leading fungal cause of HIV-related deaths globally, with the majority occurring in Africa. The human immune response to C. albicans infection has been studied extensively in large genomics studies whereas cryptococcal infections, despite their severity, are comparatively understudied. Here we investigated the transcriptional response of immune cells after in vitro stimulation with in vitro C. neoformans, C. gattii and C. albicans infection of peripheral blood mononuclear cells (PBMCs) collected from healthy South African volunteers. We found a lower transcriptional response to cryptococcal stimuli compared to C. albicans and unique expression signatures from all three fungal stimuli. This work provides a starting point for further studies comparing the transcriptional signature of CM in immunocompromised patients, with the goal of identifying biomarkers of disease severity and possible novel treatment targets.

Transungual Penetration and Antifungal Activity of Prescription and Over-the-Counter Topical Antifungals: Ex Vivo Comparison.

Topical antifungals for toenail onychomycosis must penetrate the nail to deliver an inhibitory concentration of free drug to the site of infection. In two ex vivo experiments, we tested the ability of topical antifungals to inhibit growth of Trichophyton rubrum and Trichophyton mentagrophytes, the most common causative fungi in toenail onychomycosis. Seven topical antifungals were tested: three U.S. Food and Drug Administration-approved products indicated for onychomycosis (ciclopirox 8% lacquer; efinaconazole 10% solution; tavaborole 5% solution) and four over-the-counter (OTC) products for fungal infections (tolnaftate 1% and/or undecylenic acid 25% solutions). The ability to inhibit fungal growth was tested in the presence and absence of keratin. Products were applied either to human cadaverous nails or keratin-free cellulose disks prior to placement on an agar plate (radius: 85mm) seeded with a clinical isolate of T. rubrum or T. mentagrophytes. After incubation, the zone of inhibition (ZI), defined as the radius of the area of no fungal growth, was recorded. In the nail penetration assay, average ZIs for efinaconazole (T. rubrum: 82.1mm; T. mentagrophytes: 63.8mm) were significantly greater than those for tavaborole (63.5mm; 39.1mm), ciclopirox (7.4mm; 3.6mm) and all OTC products (range: 10.5-34.2mm against both species; all P < 0.001). In the cellulose disk diffusion assay, efinaconazole and tavaborole demonstrated maximal antifungal activity against both species (ZIs = 85mm); average ZIs against T. rubrum and T. mentagrophytes were smaller for ciclopirox (59.0 and 55.7mm, respectively) and OTC products (range: 31.2-57.8mm and 25.7-47.7mm, respectively). Among all antifungals tested, the ability to penetrate human toenails to inhibit growth of both T. rubrum and T. mentagrophytes was greatest for efinaconazole, followed by tavaborole. These results indicate superior transungual penetration of efinaconazole compared to the other antifungals, suggesting lower keratin binding in the nail.

A cross sectional study on the prevalence of dermatomycosis at a tertiary care centre In Western Maharashtra

Abstract Background: Dermatomycosis is an infectious disease of the skin, hair, and nails, caused by various conditionally pathogenic fungi. Typical pathogens include Trichophyton, Microsporum, and Epidermophyton. These infections are common in humid climates, such as those found in India, and present a unique set of challenges and considerations. Currently, the number of patients with chronic dermatomycosis is increasing steadily. The present study was done to assess the prevalence and distribution of various causative fungal pathogens and their correlation with age, sex, and clinical presentation. Objectives: The objective of the study was to study the prevalence of dermatomycosis and to determine the etiological fungal pathogen causing the skin lesions. Methodology: In this cross-sectional study, in 6 months (March 2023–September 2023), 59 skin scrapings were collected from the 59 clinically diagnosed dermatomycosis patients. All the standard measures were followed to isolate the fungal pathogens using KOH mount, culture methods, and appropriate tests as per the availability of resources. Results: In this study, it was observed that the age group 21–30 years was the more prevalent age group, common in men and Tinea corporis was the most common clinical presentation. Out of 59 specimens, 17 were direct microscopy positive, i.e. KOH revealed fungal elements or yeast cells and 36 were culture positive. Trichophyton mentagrophytes was the most prevalent isolate. Conclusion: Pune is a subtropical region characterized by hot summers, relatively mild winters, and a monsoon season. The humidity of the region contributes to the proliferation of the dermatophytes. Hence, this study provides us with a detailed observation of the prevalence of dermatomycosis and causative fungal etiology. In this study, we isolated the causative fungal pathogens in addition to dermatophytes; it gives us a wide range of causative fungi and their treatment modalities as differ with yeast and mold.

Fungal Keratitis, Epidemiology and Outcomes in a Tropical Australian Setting.

Fungal keratitis is an ophthalmic emergency that can cause visual impairment and blindness. We reviewed the epidemiology and clinical features of fungal keratitis in a tropical Australian setting. To document the clinical and microbiological characteristics of fungal keratitis in an Australian tropical setting. A retrospective cohort study of patients with fungal keratitis from October 2014 to December 2022 was conducted at Royal Darwin Hospital, Northern Territory, Australia. We reviewed all patients with culture-proven fungal keratitis and their outcomes. There were 31 patients identified. Aboriginal and Torres Strait Islander (ATSI) patients were of a significantly younger median age (28 years) compared to non-ATSI patients (42 years), and they also presented later to health care. Contact lens use and ocular trauma were the most common predisposing factors. Most patients presented with a corneal infiltrate and corneal epithelial defect, and the central visual axis was affected in 54% of patients. Curvularia spp. and Fusarium spp. were the commonest causative fungi (39% and 30% respectively). Our series is different and reveals a wider range of fungal species identified over the 7 years of the study, in particular, a range of Curvularia spp. were detected. Access to eye health services in rural and remote settings is important, particularly for ATSI patients, as morbidity remains high.

Pathological investigation and morpho-molecular characterisation of Lasiodiplodia theobromae causing fruit rot diseases on Hydnocarpus longipedunculatus – A novel host record from India

Hydnocarpus longipedunculatus, a medically significant tree species, is threatened and has a narrow distribution, being endemic to the Southern Western Ghats of India. A case of fruit rot disease was observed in a solitary tree of H. longipedunculatus in the Kulamavu forest areas of Kerala, India. The causative fungus, Lasiodiplodia theobromae, was isolated and identified through a combination of morpho-cultural characteristics and molecular sequence analysis involving the internal transcribed spacer (ITS), partial translation elongation factor-1-α (TEF1-α), partial β-tubulin (TUB2), and large subunit ribosomal ribonucleic acid (LSU) regions. Additionally, concatenated multigene (ITS-TEF1-α-TUB2) phylogenetic analysis was done. Pathogenicity tests were conducted in vitro using mycelial disc methods and confirmed the pathogenic nature of the fungus through re-isolation and morphocultural analysis, satisfying Koch's postulates. Previous studies neither have reported H. longipedunculatus as a host for L. theobromae, nor has any genus within Hydnocarpus. Therefore, this represents the first documented instance of H. longipedunculatus as a novel host record for L. theobromae from India.

Monoclonal-Antibody-Based Immunoassays for the Mycotoxins NX-2 and NX-3 in Wheat.

The fungal infestation of crops can cause major economic losses. Toxins produced by the causative fungi (mycotoxins) represent a potential safety hazard to people and livestock consuming them. One such mycotoxin is deoxynivalenol (DON, also known as vomitoxin), a trichothecene associated with Fusarium Head Blight of wheat. DON is commonly found in cereal crops worldwide. A group of trichothecene mycotoxins closely related to DON, the NX toxins, have been reported to occur in the northeastern United States and southern Canada. While many commercial immunoassays are available to detect DON, there are no rapid screening assays for the NX toxins. We describe the development and isolation of three monoclonal antibodies (mAbs) specific towards two NX toxins: NX-2 and NX-3. The mAbs did not recognize DON or several other closely related trichothecenes. One of the mAbs was selected for development of an enzyme-linked immunosorbent assay (ELISA) for NX-2 and NX-3 in wheat. The dynamic ranges for the assay were 7.7 to 127 μg/kg for NX-2 and 59 μg/kg to 1540 μg/kg for NX-3 in wheat. Recoveries from spiked wheat averaged 84.4% for NX-2 and 99.3% for NX-3, with RSDs of 10.4% and 11.3%, respectively (n = 24). The results suggest that this assay can be used to screen for NX toxins in wheat at levels relevant to human food and animal feed safety.

Infectious etiologies of persistent and chronic diarrhea in Asian developing countries: A systematic review and meta-analysis.

Infectious causes of diarrhea contribute significantly to morbidity in Asia. We conducted a systematic review and meta-analysis of the prevalence of infectious etiologies of persistent and chronic diarrhea in Asian adults. Searches were performed on PubMed and Scopus for studies from January 1, 1970, to May 30, 2023. Sixteen studies were identified and included. The meta-analysis was conducted with the random-effects method, estimating the pooled prevalence of groups of infectious pathogens as causes of persistent and chronic diarrhea among Asian adults. The findings were highly heterogeneous and indicative of publication bias. The majority of studies were conducted on persons living with human immunodeficiency virus infection (PLHIV). The studies were predominantly from low-income and middle-income Asian countries. The most common cause was parasitic, with a pooled prevalence of 0.52 (95% confidence interval 0.28-0.65, I2=99%, Cochran's Q=1027.44, P<0.01), followed by bacterial, fungal, and viral causes, which were substantially rarer. Negative microbiological testing was also common, with a pooled prevalence for a negative test being 0.37 (95% confidence interval 0.17-0.52, I2=99%, Cochran's Q=1027.44, P<0.01). Subgroup analyses of studies conducted among PLHIV, from year 2000 and among those conducted in Southeast Asia showed a similar prevalence of parasitic causes of diarrhea. In conclusion, inAsian adults with persistent and chronic diarrhea, parasitic causes were most prevalent. However, the estimate of true prevalence is limited by significant heterogeneity among the available studies. More study in this field is required, especially examining PLHIV in the post-antiretroviral therapy era and from high-income countries.

First Report of Alternaria alternata Causing Leaf Spot on Smooth Bromegrass (Bromus inermis Leyss.) in China.

Smooth bromegrass (Bromus inermis Leyss.) is an important forage crop in northern China. In July 2021, leaf spot symptoms were observed on smooth bromegrass in Ewenki Banner, Hulunbuir, Inner Mongolia. In an area of approximately 0.12 hectares, 95% disease incidence was observed. Ten diseased plants were collected for pathogen isolation. Leaf tissues near the lesions were cut into 5 × 5 mm pieces, surface-disinfested in 75% ethanol for 3 min, and rinsed with sterile distilled water. The pieces were placed on water agar in petri plates and incubated at 25℃ for three days. The resulting colonies were flushed with sterile water and a spore suspension was serially diluted and plated on potato dextrose agar (PDA). A single-spore colony was obtained. Ten isolates were obtained and designated HE1 to HE10. The colony morphology was identical for all isolates, grayish white in color on the upper surface and light black on the underside. The mycelia were light gray and velvety. Conidia were light brown to brown in color and oblate, oblong or oval. The conidial dimensions were typically between 15 to 43 μm by 8 to 9 μm in size. The conidia possessed one to six transverse septa, with slight to distinct constrictions at each division, and zero to two longitudinal septa. These morphological characteristics resembled Alternaria alternata (Fr.) Keissl.. DNA was extracted from three isolates, HE3, HE4 and HE5, using the CTAB method. Polymerase chain reaction (PCR) was performed on the extracted DNA with a set of primers ITS1/ITS4, H31a/H31b, gpd1/gpd2, TEF1-728F/TEF1-986R, and RPB2-5F2/fRPB2-7cR. The amplicon sequences from the three isolates were analyzed using the BLAST in GenBank (https://www.ncbi.nlm.nih.gov/). The results showed a high sequence identity, ranging from 99 to 100%, with the A. alternata strain YTMZ-20-2 across all the genetic markers tested. The strong match reinforced the identification of the strains as A. alternata. The sequences were deposited in GenBank (Table S1). The three fungal isolates were identified as A. alternata based on their morphological and genetic data. To conduct Koch's postulates, the representative isolate HE4 was used. Smooth bromegrass seed was soaked in water for four days and sown in potting soil contained in plastic pots (10 cm diameter × 15 cm height, five seeds/pot) in a greenhouse under a 16-h photoperiod at temperatures between 20 to 25°C and 60% relative humidity. When the plants reached a height of approximately 20 cm, the plants in three pots (replicates) were sprayed with a spore suspension (106 conidial/ml) at 10 ml/pot, and three pots were sprayed with sterile water for control. Five days after inoculation, the plants exhibited leaf spot symptoms similar to those previously described, while the control plants remained unaffected. The causative fungus was successfully re-isolated from the diseased plants and confirmed morphologically and molecularly on its identity as described above. This experiment was independently conducted three times. This is the first report of A. alternata causing leaf spot on smooth bromegrass in China. Since there is risk that the disease could seriously reduce the yield of the forage crop smooth bromegrass, further research is needed.

Evaluation of Pinto Genotypes of Common Bean for Resistance to Anthracnose

ABSTRACTCommon bean (Phaseolus vulgaris L.) is an important crop grown for household revenue, food, and nutrition security in many parts of the world, especially in Africa and Latin America. Anthracnose caused by Colletotrichum lindemuthianum is a major disease of common bean globally. The objective of this study was to determine the response of selected pinto bean genotypes to seven races of C. lindemuthianum the causative fungus for anthracnose. A total of 56 pinto bean genotypes and three checks were evaluated for resistance to C. lindemuthianum races 51, 65, 73, 247, 253, 263, and 1085. Significant differences were observed among the 56 pinto genotypes in their reaction to the seven races, which was generally skewed towards susceptibility except for races 51 and 73. There was no genotype that was resistant to all seven races. In general, the genotypes that showed resistance to most of the races were those that carried Co‐42, which highlighted the importance of this locus to anthracnose resistance in pinto beans. Three genotypes—NDZ14006‐4, NDZ14110‐4, and NDZ14043—showed superior resistance (resistant to six of the seven races).

Identification and Pathogenicity of Species Isolated from Stored Potato Tubers Showing Symptoms of Dry Rot Disease

AbstractDisease arises during the storage of potatoes as a result of pathogens introduced during growing and harvest of the tubers. In this study, the causative fungi of domestic potato dry rot disease were identified, and their pathogenicity was confirmed. A total of 76 species were isolated from 93 potato necropods collected from samples inoculated with dry rot disease. These 76 isolates were identified as Fusarium boothii, F. circinatum, F. citricola, F. foetens, F. iranicum, F. longifundum, F. oxysporum, F. pseudoanthophilum, F. solani, Botryotinia ranunculi, Clonostachys rosea, and Humicola nigrescens. The average size of the inoculation site was ≥ 4.6 mm in F. oxysporum and F. solani, which were pathogenic to dry rot in potatoes but were not pathogenic compared to other strains up to 5 weeks in a 15 to 20 °C and 99% RH environment. The pathogenicity of F. foetens and F. pseudoanthophilum was related to a strong relationship by forming a single system with F. oxysporum. However, except for F. oxysporum and F. solani, these strains have not yet been reported to be associated with dry rot disease. Additionally, the length of the cross-section and longitudinal section of the potato damage symptom inoculated with C. rosea increased the most among all strains. This suggests that C. rosea is the dominant species involved in domestic potato dry rot disease. By contrast, there are no reports of the involvement of B. ranunculi and H. nigrescens in dry rot disease. Therefore, these strains can be seen as parasitic using potato sclerosis as nutrients in in vivo experiments through wounds and are not directly related to dry rot disease.

Surveillance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis During the COVID-19 Pandemic - United States, 2019-2021.

Coccidioidomycosis, histoplasmosis, and blastomycosis are lower respiratory tract fungal infections whose signs and symptoms can resemble those of other respiratory illnesses, including pneumonia caused by bacterial or viral etiologies; this overlap in clinical presentation might lead to missed or delayed diagnoses. The causative fungi live in the environment, often in soil or plant matter. To describe the epidemiologic characteristics of cases of coccidioidomycosis, histoplasmosis, and blastomycosis during the COVID-19 pandemic, CDC analyzed case surveillance data for 2019-2021. During this period, a total of 59,655 coccidioidomycosis cases, 3,595 histoplasmosis cases, and 719 blastomycosis cases were reported to CDC. In 2020, fewer cases of each disease occurred in spring compared with other seasons, and most cases occurred in fall; national seasonality is not typically observed, and cases were seasonally distributed more evenly in 2019 and 2021. Fewer cases coinciding with the start of the COVID-19 pandemic, along with an unusually high blastomycosis case fatality rate in 2021 (17% compared with more typical rates of 8%-10%), suggest that the pandemic might have affected patients' health care-seeking behavior, public health reporting practices, or clinical management of these diseases. Increased awareness and education are needed to encourage health care providers to consider fungal diseases and to identify pneumonia of fungal etiology. Standardized diagnostic guidance and informational resources for fungal testing could be incorporated into broader respiratory disease awareness and preparedness efforts to improve early diagnosis of coccidioidomycosis, histoplasmosis, and blastomycosis.

Active compounds of Michelia champaca bark extract against Curvularia verruculosa fungi causing leaf spot disease in rice (Oryza sativa L.)

Curvularia verruculosa fungal causes leaf spot disease in rice plants. The bark extract of Michelia champaca could inhibit the growth of the fungi. The present research aimed to know the active compound responsible for antifungal activity. Extraction was done using the Maceration method, antifungal activity was measured using the Diffusion well method, and identification of active compounds was carried out using Gas chromatography-mass spectroscopy (GC-MS). The methanol extract obtained had a yield of 18.7%. It showed strong activity against C. verruculosa with an inhibition zone until 30.01 mm. The fractionation results showed that n-hexane extract (HE) was the strongest inhibiting the growth of C. verruculosa (32.45 mm), followed by chloroform extract (CE) (29.20 mm), while n-butanol extract (BE) was not active. Separating active compounds from HE extract was made using Column chromatography (CC) method with silica gel as the stationary phase and the mixture of n-hexane-acetone (3:1) as the mobile phase. This separation resulted in 5 combined fractions; HE3 and HE5 extracts showed very strong activity against C. verruculosa, with a diameter of the inhibition zone of 26.73 and 33.46 mm, respectively; HE2 extract showed strong activity with a diameter of the inhibition zone of 15.21 mm, while HE1 and HE4 extracts did not show activity. Identification using GC-MS, especially the HE3 extract, revealed that the extract contained two compounds: tributyl acetyl citrate and terephthalic acid, dodecyl-2-ethylhexyl ester. The result indicated that the bark extract of M. champaca had the potential to be a botanical fungicide.

Revised ISHAM-ABPA working group clinical practice guidelines for diagnosing, classifying and treating allergic bronchopulmonary aspergillosis/mycoses.

The International Society for Human and Animal Mycology (ISHAM) working group proposed recommendations for managing allergic bronchopulmonary aspergillosis (ABPA) a decade ago. There is a need to update these recommendations due to advances in diagnostics and therapeutics. An international expert group was convened to develop guidelines for managing ABPA (caused by Aspergillus spp.) and allergic bronchopulmonary mycosis (ABPM; caused by fungi other than Aspergillus spp.) in adults and children using a modified Delphi method (two online rounds and one in-person meeting). We defined consensus as ≥70% agreement or disagreement. The terms "recommend" and "suggest" are used when the consensus was ≥70% and <70%, respectively. We recommend screening for A. fumigatus sensitisation using fungus-specific IgE in all newly diagnosed asthmatic adults at tertiary care but only difficult-to-treat asthmatic children. We recommend diagnosing ABPA in those with predisposing conditions or compatible clinico-radiological presentation, with a mandatory demonstration of fungal sensitisation and serum total IgE ≥500 IU·mL-1 and two of the following: fungal-specific IgG, peripheral blood eosinophilia or suggestive imaging. ABPM is considered in those with an ABPA-like presentation but normal A. fumigatus-IgE. Additionally, diagnosing ABPM requires repeated growth of the causative fungus from sputum. We do not routinely recommend treating asymptomatic ABPA patients. We recommend oral prednisolone or itraconazole monotherapy for treating acute ABPA (newly diagnosed or exacerbation), with prednisolone and itraconazole combination only for treating recurrent ABPA exacerbations. We have devised an objective multidimensional criterion to assess treatment response. We have framed consensus guidelines for diagnosing, classifying and treating ABPA/M for patient care and research.

Tinea Cruris

Tinea cruris is a dermatophytosis caused by Tricophyton rubrum and Epidermophyton floccosum found on the skin of the thighs, genitals, buttocks, around the anus and perineum. The typical clinical symptoms of tinea cruris are itching that increases when sweating, with polycyclic/round lesions with firm boundaries, polymorphic efflorescence, and more active edges. The diagnosis is based on history taking and dermatologic physical examination. In this case the patient is an 18-year-old female, presenting with a chief complaint of reddish and scaly patches on the buttocks and thigh folds that are increasingly widespread accompanied by intense itching, especially when sweating. The patient's complaint has been experienced since 3 months ago. The patient's reddish lesions appeared central healing with firm boundaries and active lesion edges arranged in a polycyclic manner. The patient underwent KOH examination and the results were spores (+) and hyphae (-).The prognosis of tinea cruris will be good if treated properly, unless re-exposure to the causative fungus.

Aspergillus fumigatus-Derived Extracellular Vesicles Mitigate Fungal Keratitis by Modulating the Immune Cell Function.

Fungal keratitis (FK) is a refractory global disease characterized by a high incidence of blindness and a lack of effective therapeutic options, and Aspergillus fumigatus (A. fumigatus, AF) is one of the most common causative fungi. This study aimed to investigate the role of extracellular vesicles (EVs) from A. fumigatus in the immune cell function and their protective role in A. fumigatus keratitis in order to explore their therapeutic potential. First, we isolated and characterized the EVs (AF-derived EVs). In vitro, we stimulated RAW264.7 cells and polymorphonuclear cells with AF-derived EVs. The expression levels of inflammatory factors increased in both immune cells along with an M1 polarization variation of RAW264.7 cells. After being incubated with AF-derived EVs, both immune cells exhibited an increased conidia-phagocytic index and a decreased conidia survival rate. In vivo, we injected EVs subconjunctivally on mice resulting in a heightened production of secretory immunoglobulin A (sIgA) in tear fluid. By the injection of EVs on mice in advance, a significant reduction in severity of A. fumigatus FK was witnessed by lower clinical scores, inflammatory appearances, and mitigated fungal load. Collectively, these results positioned AF-derived EVs as a promising and innovative immune therapy for combating FK, while also providing a platform for further investigation into developing an optimal formulation for modulating inflammation in the context of FK.