Fungal Lesions Research Articles

Alterações bucais e cuidados orais no paciente transplantado de medula óssea

General care in bone marrow transplant (BMT) patients includes routine dental evaluations, which must be included in a multi-professional context. The oral cavity is a site that favors infections with high potential for consequent bacteremia and so infectious lesions must be treated or controlled by the dentist. The aim of this review is to discuss key questions in national and international literature with reference to oral inflammatory conditions of BMT patients, both those with predisposition to complications during the transplant and those that emerge during and after myelosuppression therapy. The literature emphasizes advanced periodontal disease, which is a chronic infectious condition that must be avoided or controlled during BMT, particularly because of the presence of S. viridans. The risk factors for oral mucositis, graft-versus-host disease (GVHD) and xerostomia have not yet been defined, particularly for oral mucositis and GVHD. Promising alternatives in the treatment of oral mucositis, including cryotherapy, administration of growth factors and laser therapy, are emphatically mentioned. In children, craniofacial and dental alterations, particularly resulting from radiotherapy are relevant. The increased risk of caries is controversial, and among fungal and viral lesions, oral and oropharyngeal infections by Candida and the herpes virus are identified as being of considerable clinical importance.

Does the Occurrence of Invasive Fungal Infection in Acute Leukemia Patients, Impact on the Chemotherapy Schedule and Event-Free Survival? a Case-Control Study

Background: In acute leukemia (AL) patients, mortality rates of the most common IFI (i.e., aspergillosis and candidiasis) are well illustrated in the literature from the IFI diagnosis, as well as the rate of fungal relapse during subsequent periods at risk, such as neutropenic phases, or transplant. However, few data are available about the impact of IFI on the subsequent chemotherapy schedule and the indirect impact of IFI on the relapse-free and overall survival. Clinicians are usually reluctant to give the full chemotherapy doses on time, due to the risk of life-threatening fungal relapse during the subsequent courses. Even with secondary prophylaxis, they often delay or decrease the doses of chemotherapy. This may impact on the leukemia outcome. The aim of this case-control study was to assess the potential impact of proven or probable IFI onset on the application of the chemotherapy schedule in AL patients, and its consequences on the leukemia outcome, by comparing patients with and without IFI in a single institution. Delays and changes in chemotherapy doses and drug choices were evaluated and compared to the planned schedule in the protocol.Methods: All consecutive AL patients with a first episode of proven or probable IFI according to the EORTC-MSG criteria between 2000–2006 were reviewed. All patients have been treated in, or according to, clinical research protocols where timing and doses of chemotherapy were predefined. Patients who were planned for allogeneic transplant were excluded as those who were at their last consolidation course when they got IFI or in a palliative phase of the leukemia. Any delay, dose decrease, or dose change were defined as any difference compared to the planned schedule. We planned to include 3 control patients for each case, selected among AL patients without IFI, and matched for age, sex, type of AL, chemotherapy protocol, and year of treatment. 27 case and 76 control patients were finally included. The event-free survival (EFS) was defined as survival without evidence of relapse or progression, or death of any cause.Results: The mean age of the 27 case patients (26 myeloid and 1 lymphoblastic AL) was 52 y (± 13), the M/F ratio was 14/13 IFI (7 candidiasis, 19 aspergillosis, 1 zygomycosis) was proven for 10 patients (37%), and probable for 17 (63%). Twenty (71%) of these IFI occurred during the first induction phase. All patients were treated for their IFI with ≥ 1 antifungal, and 4 of them had a surgical resection of the main fungal lesion(s). These 27 patients were compared to 76 controls (73 myeloid and 3 lymphoblastic AL) without IFI. A delay of the next course of chemotherapy according to the planned protocol was significantly more frequent in the IFI group (16/27, 59%) than in the control group (16/76, 21%) (p=.001). Similarly, the dose or choice of the drugs was modified more frequently in the IFI group (7/27, 26%) than in the control group (6/76, 8%) (p=.037). Only 9 (33%) patients got their next chemotherapy course without any modification in time, dose, or choice of drug, vs. 19/76 (75%) in the control group (p<.0001). The EFS of the IFI group was lower than that of the control group, although this difference was not significant.Conclusion: In this single-institution case-control study, the occurrence of IFI significantly modified the application of chemotherapy courses, both on timing of the courses, and dose and choice of the drugs when compared to patients without IFI. Although the difference was not significant, there was a tendency for a lower EFS in the IFI group when compared to the control group.−

Localization of Pantoea ananatis inside lesions of maize white spot disease using transmission electron microscopy and molecular techniques

The etiological agent of maize white spot (MWS) disease has been a subject of controversy and discussion. Initially the disease was described as Phaeosphaeria leaf spot caused by Phaeosphaeria maydis. Other authors have suggested the existence of different fungal species causing similar symptoms. Recently, a bacterium, Pantoea ananatis, was described as the causal agent of this disease. The purpose of this study was to offer additional information on the correct etiology of this disease by providing visual evidence of the presence of the bacterium in the interior of the MWS lesions by using transmission electron microscopy (TEM) and molecular techniques. The TEM allowed visualization of a large amount of bacteria in the intercellular spaces of lesions collected from both artificially and naturally infected plants. Fungal structures were not visualized in young lesions. Bacterial primers for the 16S rRNA and rpoB genes were used in PCR reactions to amplify DNA extracted from water-soaked (young) and necrotic lesions. The universal fungal oligonucleotide ITS4 was also included to identify the possible presence of fungal structures inside lesions. Positive PCR products from water-soaked lesions, both from naturally and artificially inoculated plants, were produced with bacterial primers, whereas no amplification was observed when ITS4 oligonucleotide was used. On the other hand, DNA amplification with ITS4 primer was observed when DNA was isolated from necrotic (old) lesions. These results reinforced previous report of P. ananatis as the primary pathogen and the hypothesis that fungal species may colonize lesions pre-established by P. ananatis.

Invasive Fungal Infection in Acute Leukemia Patients: What Is Their Impact on the Chemotherapy Schedule?.

Invasive fungal infection (IFI) occurs in 2–12% of acute leukemia patients, with different prevalences according to centers, and phases of treatment. The mortality rates of the main IFI (i.e., aspergillosis and candidiasis) are well illustrated in the literature, as well as the risk of fungal relapse during subsequent periods at risk, such as a new neutropenic phase, or transplant. However, few data are available about the impact of IFI on the subsequent chemotherapy schedule. Clinicians are usually reluctant to give the full chemotherapy doses on time, due to the risk of life-threatening fungal relapse during the subsequent courses. Even with secondary prophylaxis which is now widely given, they usually delay or decrease the doses of chemotherapy. This may impact on the leukemia outcome.Objective: The aim of this single-institution retrospective study was to look at the impact of proven or probable IFI onset on the application of the chemotherapy schedule as planned in the initial strategy in patients with acute leukemia. Delays, and changes in chemotherapy doses and drug choices were evaluated and compared to the planned schedule in the protocole.Methods: All consecutive acute leukemia patients with a first episode of proven or probable IFI according to the EORTC-MSG criteria between 2000–2006 were reviewed. All patients have been treated in, or according to, clinical research protocols where timing and doses of chemotherapy were predefined. Patients who were planned for allogeneic transplant were excluded as those who were at their last consolidation course when they got IFI. Any delay, dose decrease or dose change were defined as any difference compared to the planned schedule.Results: 28 patients (7 candidiasis, 20 aspergillosis, 1 zygomycosis) were included (M/F: 15/13; mean age: 54y), including 27 acute myeloid leukemia and one acute lymphoblastic leukemia. Eleven (39%) were proven, 17 (61%) were probable. Twenty (71%) of these IFI occurred during the first induction phase. All patients were treated for their IFI with ≥ 1 antifungal, and 4 of them had a surgical resection of the main fungal lesion (s). Seventeen of 28 (60%) had their next course delayed (median delay: 14 days) when compared to the planned protocole. The doses of the antineoplastic drug(s) were modified in 7 (25%) patients. Only 9 (32%) patients got their next chemotherapy course without any modification in time, dose, or choice of drug. Although the number of patients in our study does not allow definite conclusions, these changes should have an impact on leukemia-free and overall survivals.Conclusion: Due to the risk of fungal relapse during a subsequent period at risk, IFI has a practical impact on the dates, doses, and choices of chemotherapy in acute leukemia in more than two thirds of the patients, due to subjective decisions of the clinicians. Effective antifungal strategies are needed to avoid the onset of IFI in acute leukemia patients.

Fungal skin infections among prison inmates in Abakaliki, Nigeria

Of 402 prison inmates screened for fungal skin lesions, 79 (19.7%) showed skin lesions, which proved mycologically positive by microscopy and culture. Dermatophytes were responsible for skin lesions in 61 (77.2%) of the inmates, while non-dermatophytes accounted for 18 (22.8%) of the lesions. The dermatophytes recovered were mostly anthropophilic and included Trichophyton rubrum 33 (41.8%); T. mentagrophytes var. interdigitale 3 (3.8%); T. tonsurans 3 (3.8%); T. violaceum 2 (2.5%); Epidermophyton floccosum 10 (12.7%). A zoophilic dermatophyte, Microsporum canis, was recovered from 10 (12.7%) cases. The non-dermatophytes were Candida albicans 15 (19%) and Candida spp. 3 (3.8%). Trichophyton rubrum was the most frequently recovered dermatophyte (41.8%) and caused infections in a variety of sites. The groin was the most common site of infection being infected in 50% of the cases by both the dermatophytes and non-dermatophytes. Younger inmates (17-24 years) recorded the highest prevalence of infection (45.6%). Newer inmates (>2 years) were found to be more infected than older ones.

Impact of low-level atmospheric ozone-enrichment on black spot and anthracnose rot of tomato fruit

Tomato fruit ( Lycopersicon esculentum L.) were exposed to ozone concentrations between 0.005 (control) and 5.0 μmol mol −1 up to 13 days at 13 °C, prior to, or following, inoculation by Alternaria alternata or Colletotrichum coccodes (causes of black spot and anthracnose, respectively). Low-level atmospheric ozone-enrichment resulted in a modest, but statistically significant, reduction in fungal lesion development; higher concentrations of the gas resulting in greater effects. This finding implies concentration-specific impacts on fungal lesion development. A fluorescent lection assay revealed that the ozone-induced inhibition of visible lesion development was reflected in a similar reduction in fungal biomass below the fruit surface. Fungal spore production in vivo, was markedly reduced when fruit were stored in an ozone-enriched atmosphere. Higher concentrations/duration of exposure resulted in greater reduction in spore production, with considerable benefits resulting from exposure to low levels of ozone (i.e. below the 0.2 μmol mol −1 European threshold used for the protection of human health). In vitro, effects of ozone on spore germination depended on concentration and duration of exposure. Studies performed on fungi exposed to ozone on Potato Dextrose Agar at 13 °C and 95% relative humidity revealed no major effects on the growth of mycelia, implying the observed suppression of pathogen development was due in part to ozone-induced changes in fruit-pathogen interactions.

Unusual survival of an adult with pleuropulmonary blastoma and neurofibromatosis

Clinical Summary Chest radiography showed a solid mass encased within a large cystic structure, suspicious for aspergilloma of the left lung. A chest computed tomographic scan revealed a huge multiseptated cystic structure involving the entire major fissure of the left lung, containing a multilobulated soft tissue mass (Figure 1), and measuring approximately 10 20 cm. The mass and cysts were completely excised through a left thoracotomy. The specimen weighed 85 g in aggregate and consisted of thin-walled cysts, imparting a botryoid (ie, grape-like) appearance, with minor solid components (Figure 2, A ). Microscopically, small immature tumor cells with ovoid to spindle-shaped nuclei were set in a myxoid stroma. Cellularity was highest in the so-called cambium layer just beneath the attenuated cyst lining (Figure 2, B). Tumor cells were positive for desmin and other muscle markers by immunohistochemistry. A diagnosis of pleuropulmonary blastoma (PPB) type II was made. The patient’s postoperative course was uneventful. Retrospective pathologic examination of the blebectomy specimen obtained 2 years earlier revealed subtle histologic features suggestive of PPB type I. The patient received a multidrug regimen of 11 cycles of chemotherapy, consisting of vincristine, actinomycin, and cyclophosphamide during the first phase, and doxorubicin (Adriamycin; Bedford Laboratories, Bedford, Ohio), cisplatin, and doxorubicin during the second phase. Follow-up computed tomography scans of the chest, abdomen, and pelvis revealed no evidence of recurrence or metastasis at 24 months. The patient is currently asymptomatic with good weight gain and normal physical strength. Discussion This case report demonstrates the cardinal clinical and pathologic features of PPB, a highly aggressive childhood malignancy, in an adult. These tumors present almost exclusively in the first decade of life. 1 To our knowledge, 4 adult patients have been reported in the literature, with only 1 survivor at 29 months, after radiation therapy of a nonresectable PPB. 2 It is now recognized that 25% of PPB cases occur in a familial setting with other tumors of childhood, such as cystic nephroma, rhabdomyosarcoma, and synovial sarcoma. 3 There are no reports in the literature of any case of PPB associated with neurofibromatosis. Clinical presentation of these rare tumors may vary from ruptured lung blebs, as in our patient, or space-occupying masses resembling a mediastinal teratoma 4 to more subtle manifestations of chest pathology or systemic disease. The clinical and radiographic differential diagnosis includes fungal lesions, congenital cystic adenomatoid malformation, bronchogenic cyst, and postinfectious pneumatocele. Three pathologic types of PPB have been described: Type I is purely cystic and may present as a congenital lung cyst; type II is a combined cystic and solid tumor; and type III is solid and can be accompanied by hemorrhage and necrosis. 2

Fungal versus bacterial brain abscesses: is diffusion-weighted MR imaging a useful tool in the differential diagnosis?

The aim of this study was to investigate the appearance of fungal brain abscesses on diffusion-weighted (DW) images, and to evaluate whether the imaging characteristics and apparent diffusion coefficient (ADC) values associated with fungal abscesses were distinct from those of bacterial abscesses. We retrospectively reviewed the MR images from nine patients with fungal brain infections, and 17 patients with pyogenic brain abscesses. All patients underwent conventional MR sequences and DW imaging on 1.5-T clinical MR scanners. ADC values of 20 fungal and 20 bacterial brain abscesses were calculated and compared using a random factor analysis of variance. Multiple lesions were present in 6 of 9 patients (67%) with fungal abscesses and in 5 of 17 patients (29%) with bacterial abscesses. On DW images, all but one bacterial brain abscess showed a homogeneous high signal, whereas the appearance of fungal abscesses on DW images was more variable: in five of nine patients with fungal abscesses, the lesions were homogeneously hyperintense, while in the remaining four patients, the lesions were of mixed signal intensity. Mean ADC values were 0.74 x 10(-3) mm(2)/s in the fungal group and 0.486 x 10(-3) mm(2)/s in the bacterial group (P< or =0.05). Our results indicate that there is a trend towards higher ADC values in fungal lesions. Additional findings that support fungal rather than bacterial cerebral infection are multiplicity, signal heterogeneity on T2-weighted and DW imaging, and involvement of deep grey-matter nuclei.

Identification of quantitative trait loci affecting virulence in the basidiomycete Heterobasidion annosum s.l.

Identification of virulence factors of phytopathogens is important for the fundamental understanding of infection and disease progress in plants and for the development of control strategies. We have identified quantitative trait loci (QTL) for virulence on 1-year-old Pinus sylvestris and 2-year-old Picea abies seedlings and positioned them on a genetic linkage map of the necrotrophic phytopathogen Heterobasidion annosum sensu lato (s.l.), a major root rot pathogen on conifers. The virulence of 102 progeny isolates was analysed using two measurements: lesion lengths and fungal growth in sapwood from a cambial infection site. We found negative virulence effects of hybridization although this was contradicted on a winter-hardened spruce. On P. abies, both measurements identified several partially overlapping QTLs on linkage group (LG) 15 of significant logarithm of odds (LOD) values ranging from 2.31 to 3.85. On P. sylvestris, the lesion length measurement also identified a QTL (LOD 3.09) on LG 15. Moreover, QTLs on two separate smaller LGs, with peak LOD values of 2.78 and 4.58 were identified for fungal sapwood growth and lesion lengths, respectively. The QTL probably represent loci important for specific as well as general aspects of virulence on P. sylvestris and P. abies.

Spawning‐related fungal infection of golden galaxias Galaxias auratus (Galaxiidae)

The occurrence of golden galaxias Galaxias auratus with dermal fungal lesions in two populations was effectively modelled by the progression of gonadal stages of development. Skin lesions were found to be characteristic of fungal dermatitis and a Saprolegnia sp. was identified as the causative agent. Infection is probably linked to spawning‐related factors and it is probable that saprolegniasis is associated with seasonal mortality.

Role of Endoscopy in the Management of Highly Invasive Fungal Skull Base Lesions

Role of Endoscopy in the Management of Highly Invasive Fungal Skull Base Lesions

Results of a multicenter retrospective study of a combined medical and surgical approach to pulmonary aspergillosis in pediatric neutropenic patients

Invasive aspergillosis (IA) is a serious problem in patients suffering from hematological malignancies. Surgical resection has been reported to improve disease control and patient survival. There are few reports describing the role of surgery in children with pulmonary IA. From October 1998 to September 2005, 21 patients fulfilled the inclusion criteria. Demographic and clinical data, as well as type and duration of antifungal therapy; surgery and related complications; time elapsing from surgery to resumption of chemotherapy were collected retrospectively through a specially designed form filled in by each investigator. Eleven males and 10 females, aged between 2 and 17 years underwent one or more surgical lung resections for diagnostic and therapeutic purposes. Surgical complications were reported in three patients. Two patients, who underwent a wedge resection and a lobectomy, respectively, had no fungal lesions detected at surgery. Seventeen of 20 patients with malignancy resumed chemotherapy after a median of 19 days from surgery, range 7-81, and 11 of them underwent hematopoietic stem cell transplantation after a median time of 60 days from surgery, range 19-110. After a median follow-up of 1.7 years, 12 patients are alive while 9 patients have died from progression of their underlying disease. This study suggests that the combination of medical antifungal therapy and early surgical excision is a feasible and an effective strategy in pediatric patients with IA. In order to avoid unnecessary surgical procedures, we advise checking the response to antifungal therapy by chest-computed tomography immediately before the date of surgery.

Invasive Aspergillosis (IA) In Patients Treated in the Institute of Tuberculosis and Chest Diseases in the Years 1993–2005—Diagnostic Problems

The aim of this study was to present the diagnostic problems in pts treated for invasive aspergillosis (IA) in the IIIrd Clinic of the Institute of Tuberculosis in the years 1993-2005. The material consisted of clinical documentation of 18 pts. 15 out of 18 pts (83,4%) died. In all those cases autopsy examination was done. In 13 pts IA was the main and in another 2 only the accessory cause of death. All pts were treated with corticosteroids and/or cytostatic drugs because of lung cancer (13 pts), haematologic disorders (1 pts), Wegener's granulomatosis (3 pts) and idiopathic pulmonary fibrosis (1 pts). In 13 out of 18 pts granulocytopenia was revealed (on an average from 0,008 x 10(9)/L to 0,95 x 10(9)/L) one month before death. In 13 pts IA was limited to the lungs, in 5 others there were also fungal lesions in brain, kidneys, liver, spleen, pleura, pericardium and heart. Pts with disseminated form of IA had significantly lower granulocyte count and were treated with higher doses of corticosteroids than others. Immunosupressive drugs and granulocytopenia can be regarded as predisposing factors. IA was diagnosed before death only in 5 out of 18 pts. This was mainly caused by the lack of the symptoms of infection (4 pts) and negative results of mycological (6 pts) and serological examination (8 pts). We should underline that mycological examination was only done in 11 pts and serological examination of blood for fungal antigen only in 6 pts. We conclude that mycological infection ought to be searched in all pts treated with high doses of corticosteroids and those with prolonged granulocytopenia, especially if they have the symptoms of infection which does not respond to antibiotic therapy.

Indole‐3‐acetic acid attenuates the fungal lesions in infected potato tubers

In this report, we demonstrated that potato tubers pre‐treated with 100 µM of indole‐3‐acetic acid (IAA) and then inoculated with Fusarium solani f. sp. eumartii (F. eumartii) showed a decrease in the fungal lesion compared with non‐IAA pre‐treated and inoculated tubers. Consequently, we tested the addition of different concentrations of IAA on the fungal growth and on the proteolytic activity when the fungus was grown in liquid culture medium. Fungal growth did not change under different phytohormone concentrations, but the activity of Fusarium extracellular serine protease (FESP) clearly decreased. The inhibition of FESP activity by IAA was dose dependent. Moreover, FESP as well as others extracellular pectinolytic activities detected in IAA pre‐treated and inoculated tubers decreased compared with controls. In addition, the ability of IAA production by F. eumartii was tested, and the role of IAA on potato–F. eumartii interaction is discussed.

Identification and characterization of potato protease inhibitors able to inhibit pathogenicity and growth of Botrytis cinerea

Different tissues of potato, tobacco, and bean plants were screened for anti-fungal protease inhibitor (PI) activity, also following fungal pathogen inoculation or mechanical wounding. A potato ( Solanum tuberosum var. Desireé) sprout protein extract showed a strong inhibitory activity against chymotrypsin and Botrytis cinerea fungal proteases, but also on spore germination, hyphal elongation, and development of necrotic lesions. An active mixture of different proteins was affinity column purified and sequenced. Two new anti-fungal genes, PKI1 and PPI3B2, coding, respectively, for a Kunitz-type inhibitor and a Proteinase Inhibitor 1 capable of reducing fungal lesion development, were cloned and partially characterized. Direct effect on leaf necrosis formation was found to be dependent on the anti-chymotrypsin activity of both selected inhibitors. The PKI1 transcript was found to accumulate in untreated sprout tissues, although homologues of this gene seemed to accumulate following Bemisia tabaci attack. In the case of PPI3B2, we provide preliminary evidence that a member of the Proteinase Inhibitor 1 family is active against not only herbivorous insects but also phytopathogenic fungi and foliar lesions caused by them.

Efficacy of Caspofungin as Secondary Prophylaxis in Patients Undergoing Stem Cell Transplantation with Prior Pulmonary and/or Systemic Fungal Infection.

Fungal infections (FI) are a major cause of TRM after stem cell transplantation (SCT). Within a prospective phase II study of secondary prophylaxis, Caspofungin 70 mg followed by 50 mg daily, was given iv from the start of conditioning regimen until either day +30 or stable engraftment of PMN>1x109/l. Oral Itraconazol was given after suspension of Caspofungin. 27 patients with history of possible (n=14) probable (n=8) or proven (n=5) FI in the past were included in this study. 21 patients were affected by AL, 3 by NHL and 1 by HD, LMC and MDS, respectively. Prior FI was diagnosed at a median of 4.11 months (0.56–25.10) before SCT. Site of FI was pulmonary in 26 patients, associated in 3 cases with liver, skin or liver + spleen, respectively. In 1 patient, FI consisted of multiple liver, spleen and kidney localizations following candidemia. In the 5 proven infections, the fungal agent was aspergillus fumigatus in 2 cases, aspergillus flavus in 1, aspergillus terreus and niger in 1 and candida albicans in 1. SCT were HLA-matched related (n=14), unrelated (n=8) or autologous (n=5). Standard regimen was given to 19 and reduced intensity to 8 cases. Patients were followed for 6 months after SCT and evaluated at days 30 and 180. In 12 patients, pharmacodynamic and kinetic properties of Caspofungin were determined by HPLC with fluorescence detection at the end of 1h infusion the first day and then weekly within 28 days of treatment (peak and trough levels). Caspofungin was well tolerated with no evidence of side effects in all cases. 3 patients died before day 30 for TRM (n=2) or leukemia relapse (n=1). In the first 2 cases no sign of FI was evident, while in the last patient a concomitant progression of the previous probable FI was present. 1 patient had treatment discontinued before day +30 for VOD, but was evaluated for response of FI. Of the 24 surviving patients at day +30, 8 improved and 16 had stable FI. 3 patients died between day 30 and 180 for TRM (n=2) or leukemia progression (n=1) and 6 were too early for day 180 evaluation, although in no case progression of the previous FI was documented. Of the 15 patients evaluated at day 180, 8 showed a further improvement of fungal lesions, while 7 maintained stable FI. When only probable and proven infections were considered, 3/10 surviving patients at day 30 improved and 7 had stable infection, while in the 6 patients evaluated at day 180, the previous FI was improved in 3 and stable in 3. Mean plasma drug concentrations were maintained above the target of 1 mg/L in all measurements, therefore exceeding MIC90 of the most clinically relevant species of Candida and Aspergillus sp, while the AUC/MIC ratio was ≥100 for isolates with MIC ≤1 mg/L. In conclusion, we confirmed that Caspofungin is a safe antifungal agent in patients undergoing SCT and the maintenance of effective plasma levels during the period of administration allows an optimal prophylaxis in patients at high risk of invasive FI.

Initial Infection and Colonization of Leaves and Stems of Cling Peach by Tranzschelia discolor

ABSTRACT Initial infection processes and the subsequent colonization of leaves and young stems of peach by Tranzschelia discolor were studied. On leaves where multiple disease cycles of peach rust occur during the growing season, urediniospores germinated after 4 h of wetness. Germ tubes became septate and formed appressoria only over leaf stomata beginning 18 h after inoculation. No appressoria, however, formed over stomata of positive replicas of leaf surfaces indicating nonthigmotropic responses of germ tubes. On young, primary-growth stems (ca. 8 weeks old), stomata were mostly closed, less frequent than on leaves, and recessed from the surface of the cuticle of the epidermis. Although appressoria formation was not observed on inoculated stems, germ tube growth of urediniospores was directional toward stomata. Penetration of stem tissue is apparently a less common event that was reflected by a lower occurrence of stem lesions compared with that of leaf lesions in our potted plant inoculation studies and previous field observations. Still, stem lesions are important as sources of primary inoculum each spring and were reproduced in this study for the first time. Fungal colonization of leaves and stems was subepidermal-intercellular and haustoria were commonly found within mesophyll or cortical cells, respectively. No fungal colonization was observed in cambial stem tissue. Vascular tissue was also not colonized and delimited lesions in leaves and stems. Morphological host responses were not observed in infections on either leaves or young stems. In older stems (>32 weeks old), however, the infection was delimited by a wound periderm after uredinial formation. Furthermore, with continued secondary growth, stems recovered and fungal lesions became part of the bark tissue of woody branches. Thus, the fungus must infect primary-growth branches each year to establish stem lesions.

A study of dermatophytosis in South West of Iran (Ahwaz)

Two hundred and seventy nine patients suspected of having fungal lesions were examined. Skin scrapping, hair samples and nail clippings were collected from patients. Direct and culture examinations were performed for all samples. About 115 cases of examined subjects had dermatophytosis. Dermatophytosis occurred mainly in adults males (20-29 years). Tinea cruris (24.3%) was the most common type of dermatophytosis followed by tinea pedis (16.5%), tinea corporis (14.8%), tinea ungium (13%), tinea capitis (11.3%), tinea faciei (11.3%), tinea manuum (7%) and tinea barbae (1.7%). Trichophyton mentagrophytes was the most prevalent species followed by Epidermophyton floccosum.

Hard palate perforation due to invasive aspergillosis in a patient with acute lymphoblastic leukemia

Invasive aspergillosis (IA) is a major cause of morbidity and mortality in immunosuppressed patients. Primary oral invasive aspergillosis is a rare condition. We present an acute lymphoblastic leukemia (ALL) patient with hard palate perforation due to invasive aspergillosis. Two months after the appearance of the fungal lesions, perforation of the hard palate was seen despite amphotericin-b and itracanazole therapy. After debridement of necrotic tissue the patient was followed for spontaneous closure for 6 months but it was seen that the fistula persisted despite the disappearance of the infection. The patient was operated for closure of the palatal fistula and there was no recurrence in 6 months of follow up. Surgical and medical management was performed successfully. Invasive oral aspergillosis is a potentially lethal disease and it should be considered in immunosuppressed patients with oral lesions.

Mortality Due to Aspergillosis in Wild Swans in Northwest Washington State, 2000–02

Abstract During the winters of 2000–01 and 2001–02, 400 trumpeter (Cygnus buccinator; n = 365) and tundra (Cygnus columbianus columbianus; n = 35) swans died in northwest Washington State. The carcasses were collected and frozen for necropsy, completed in May 2001 (n = 172) and May 2002 (n = 228). Although most swans died of lead poisoning, 64 (16%) swans had gross pathologic lesions consistent with aspergillosis (trumpeter swan, n = 62; tundra swan, n = 2). Mild fungal infections consisted of small, nonobstructive lesions in the air sacs, trachea, or lungs, with lesions isolated to 1 area. Severe fungal infections consisted of large, extensive infiltrating lesions in the respiratory tract, with 68% of lesions in more than 1 area (lungs, air sacs, or trachea) and many with complete fibrinous casts within air sacs or trachea. Male swans were twice as likely as females to have fungal lesions, although there was no difference in the ratio of males and females with mild or severe infections. Juvenile swans (<...