Cargando…
Fatal pneumonia caused by Penicillium digitatum: a case report
BACKGROUND: Penicillium species are among the most common fungi present in the environment and are usually considered non-pathogenic to humans. However, in immunocompromised hosts they can be virulent pathogens and can cause death. Penicillium digitatum is a plant pathogen that commonly causes a pos...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614886/ https://www.ncbi.nlm.nih.gov/pubmed/23522080 http://dx.doi.org/10.1186/1471-2466-13-16 |
_version_ | 1782264938149969920 |
---|---|
author | Oshikata, Chiyako Tsurikisawa, Naomi Saito, Akemi Watanabe, Maiko Kamata, Yoichi Tanaka, Maki Tsuburai, Takahiro Mitomi, Hiroyuki Takatori, Kosuke Yasueda, Hiroshi Akiyama, Kazuo |
author_facet | Oshikata, Chiyako Tsurikisawa, Naomi Saito, Akemi Watanabe, Maiko Kamata, Yoichi Tanaka, Maki Tsuburai, Takahiro Mitomi, Hiroyuki Takatori, Kosuke Yasueda, Hiroshi Akiyama, Kazuo |
author_sort | Oshikata, Chiyako |
collection | PubMed |
description | BACKGROUND: Penicillium species are among the most common fungi present in the environment and are usually considered non-pathogenic to humans. However, in immunocompromised hosts they can be virulent pathogens and can cause death. Penicillium digitatum is a plant pathogen that commonly causes a postharvest fungal disease of citrus called green mould; it very rarely causes systemic mycosis in humans. Here, we report a case of fatal pneumonia due to P. digitatum infection, as confirmed by repeated examination of cultured sputum. CASE PRESENTATION: A cavity was found in the left upper lung on routine chest X-ray in a 78-year-old undernourished male who had been diagnosed at age 66 with bronchial asthma and pulmonary emphysema. No increased sputum production was present. The presence of antigen-specific precipitating antibodies to Aspergillus flavus and P. digitatum was confirmed in the patient’s serum and also later pleural fluid by using Ouchterlony double immunodiffusion testing with A. flavus and P. digitatum antigens. The patient was treated over a period of months with itraconazole, micafungin, voriconazole, amphotericin B, and antibacterials. However, the cavity enlarged, the pleural effusion increased, and the patient began producing purulent sputum. He died from progressive renal failure. From sputum culture only one fungus was isolated repeatedly on potato-dextrose agar in large quantities. This fungus was confirmed to be P. digitatum by molecular identification. Partial sequences of the beta-tubulin gene were determined by using the primers Bt2a and Bt2b for PCR amplification and sequencing and underwent a BLAST search at the National Centre for Biotechnology Information, these results confirmed that the isolated fungus was P. digitatum. CONCLUSION: To our knowledge, this is the first report of pulmonary infection with P. digitatum. Our patient had pulmonary emphysema and was elderly, and undernourished. These factors might have facilitated the infection. In his case, antimycotics were ineffective in treating the lung involvement. Although human infection with P. digitatum is considered rare, it appears that this organism can be very virulent and resistant to antimycotics. |
format | Online Article Text |
id | pubmed-3614886 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-36148862013-04-03 Fatal pneumonia caused by Penicillium digitatum: a case report Oshikata, Chiyako Tsurikisawa, Naomi Saito, Akemi Watanabe, Maiko Kamata, Yoichi Tanaka, Maki Tsuburai, Takahiro Mitomi, Hiroyuki Takatori, Kosuke Yasueda, Hiroshi Akiyama, Kazuo BMC Pulm Med Case Report BACKGROUND: Penicillium species are among the most common fungi present in the environment and are usually considered non-pathogenic to humans. However, in immunocompromised hosts they can be virulent pathogens and can cause death. Penicillium digitatum is a plant pathogen that commonly causes a postharvest fungal disease of citrus called green mould; it very rarely causes systemic mycosis in humans. Here, we report a case of fatal pneumonia due to P. digitatum infection, as confirmed by repeated examination of cultured sputum. CASE PRESENTATION: A cavity was found in the left upper lung on routine chest X-ray in a 78-year-old undernourished male who had been diagnosed at age 66 with bronchial asthma and pulmonary emphysema. No increased sputum production was present. The presence of antigen-specific precipitating antibodies to Aspergillus flavus and P. digitatum was confirmed in the patient’s serum and also later pleural fluid by using Ouchterlony double immunodiffusion testing with A. flavus and P. digitatum antigens. The patient was treated over a period of months with itraconazole, micafungin, voriconazole, amphotericin B, and antibacterials. However, the cavity enlarged, the pleural effusion increased, and the patient began producing purulent sputum. He died from progressive renal failure. From sputum culture only one fungus was isolated repeatedly on potato-dextrose agar in large quantities. This fungus was confirmed to be P. digitatum by molecular identification. Partial sequences of the beta-tubulin gene were determined by using the primers Bt2a and Bt2b for PCR amplification and sequencing and underwent a BLAST search at the National Centre for Biotechnology Information, these results confirmed that the isolated fungus was P. digitatum. CONCLUSION: To our knowledge, this is the first report of pulmonary infection with P. digitatum. Our patient had pulmonary emphysema and was elderly, and undernourished. These factors might have facilitated the infection. In his case, antimycotics were ineffective in treating the lung involvement. Although human infection with P. digitatum is considered rare, it appears that this organism can be very virulent and resistant to antimycotics. BioMed Central 2013-03-23 /pmc/articles/PMC3614886/ /pubmed/23522080 http://dx.doi.org/10.1186/1471-2466-13-16 Text en Copyright © 2013 Oshikata et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Oshikata, Chiyako Tsurikisawa, Naomi Saito, Akemi Watanabe, Maiko Kamata, Yoichi Tanaka, Maki Tsuburai, Takahiro Mitomi, Hiroyuki Takatori, Kosuke Yasueda, Hiroshi Akiyama, Kazuo Fatal pneumonia caused by Penicillium digitatum: a case report |
title | Fatal pneumonia caused by Penicillium digitatum: a case report |
title_full | Fatal pneumonia caused by Penicillium digitatum: a case report |
title_fullStr | Fatal pneumonia caused by Penicillium digitatum: a case report |
title_full_unstemmed | Fatal pneumonia caused by Penicillium digitatum: a case report |
title_short | Fatal pneumonia caused by Penicillium digitatum: a case report |
title_sort | fatal pneumonia caused by penicillium digitatum: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614886/ https://www.ncbi.nlm.nih.gov/pubmed/23522080 http://dx.doi.org/10.1186/1471-2466-13-16 |
work_keys_str_mv | AT oshikatachiyako fatalpneumoniacausedbypenicilliumdigitatumacasereport AT tsurikisawanaomi fatalpneumoniacausedbypenicilliumdigitatumacasereport AT saitoakemi fatalpneumoniacausedbypenicilliumdigitatumacasereport AT watanabemaiko fatalpneumoniacausedbypenicilliumdigitatumacasereport AT kamatayoichi fatalpneumoniacausedbypenicilliumdigitatumacasereport AT tanakamaki fatalpneumoniacausedbypenicilliumdigitatumacasereport AT tsuburaitakahiro fatalpneumoniacausedbypenicilliumdigitatumacasereport AT mitomihiroyuki fatalpneumoniacausedbypenicilliumdigitatumacasereport AT takatorikosuke fatalpneumoniacausedbypenicilliumdigitatumacasereport AT yasuedahiroshi fatalpneumoniacausedbypenicilliumdigitatumacasereport AT akiyamakazuo fatalpneumoniacausedbypenicilliumdigitatumacasereport |