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P264 Brain phaeohyphomycosis secondary to immunosuppressant therapy due to Rhinocladiella mackenziei
POSTER SESSION 2, SEPTEMBER 22, 2022, 12:30 PM - 1:30 PM: : Two cases of Rhinocladiella mackenziei have been noted in our institute, the first case in 2015 (post-renal transplant) and the second case in 2021 (post-COVID infection). Both the patients had received immunosuppressants for varying dur...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9516185/ http://dx.doi.org/10.1093/mmy/myac072.P264 |
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author | Rai, Madhu Patel, Medical Priyanka Rodriguez, Camilla Basu, Shaoli Salvi, Asmita Agrawal, Umang Sunavala, Ayesha Soman, Rajiv Shetty, Anjali |
author_facet | Rai, Madhu Patel, Medical Priyanka Rodriguez, Camilla Basu, Shaoli Salvi, Asmita Agrawal, Umang Sunavala, Ayesha Soman, Rajiv Shetty, Anjali |
author_sort | Rai, Madhu |
collection | PubMed |
description | POSTER SESSION 2, SEPTEMBER 22, 2022, 12:30 PM - 1:30 PM: : Two cases of Rhinocladiella mackenziei have been noted in our institute, the first case in 2015 (post-renal transplant) and the second case in 2021 (post-COVID infection). Both the patients had received immunosuppressants for varying duration. Both the cases presented to the hospital with neurological deficit secondary to brain abscess. On initial assessment, the melanized fungus was noted which was later identified as Rhinocladiella on culture and further confirmed with molecular methods. Both the cases were treated with injection of L AmB, voriconazole and 5FC for a prolonged duration and later discharged when the condition improved. The renal transplant patient was advised lifelong voriconazole since he would continue to be on immunosuppressants. To our knowledge, the second patient diagnosed post-COVID could be the first case report of invasive dematiaceous fungal infection in an apparently immunocompetent individual. Both cases also highlight the challenges in management such as designing an appropriate regimen, deciding the optimum duration of antifungal therapy, and managing the toxicities associated with long-term antifungal use. R. mackenziei is a frequently fatal melanized neurotropic fungus known to carry almost 100% mortality despite the combination of antifungal agents and surgery. Central nervous system infections due to R. mackenziei have been exclusively reported from the Middle East, except for cases recently reported from India. |
format | Online Article Text |
id | pubmed-9516185 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-95161852022-09-29 P264 Brain phaeohyphomycosis secondary to immunosuppressant therapy due to Rhinocladiella mackenziei Rai, Madhu Patel, Medical Priyanka Rodriguez, Camilla Basu, Shaoli Salvi, Asmita Agrawal, Umang Sunavala, Ayesha Soman, Rajiv Shetty, Anjali Med Mycol Oral Presentations POSTER SESSION 2, SEPTEMBER 22, 2022, 12:30 PM - 1:30 PM: : Two cases of Rhinocladiella mackenziei have been noted in our institute, the first case in 2015 (post-renal transplant) and the second case in 2021 (post-COVID infection). Both the patients had received immunosuppressants for varying duration. Both the cases presented to the hospital with neurological deficit secondary to brain abscess. On initial assessment, the melanized fungus was noted which was later identified as Rhinocladiella on culture and further confirmed with molecular methods. Both the cases were treated with injection of L AmB, voriconazole and 5FC for a prolonged duration and later discharged when the condition improved. The renal transplant patient was advised lifelong voriconazole since he would continue to be on immunosuppressants. To our knowledge, the second patient diagnosed post-COVID could be the first case report of invasive dematiaceous fungal infection in an apparently immunocompetent individual. Both cases also highlight the challenges in management such as designing an appropriate regimen, deciding the optimum duration of antifungal therapy, and managing the toxicities associated with long-term antifungal use. R. mackenziei is a frequently fatal melanized neurotropic fungus known to carry almost 100% mortality despite the combination of antifungal agents and surgery. Central nervous system infections due to R. mackenziei have been exclusively reported from the Middle East, except for cases recently reported from India. Oxford University Press 2022-09-20 /pmc/articles/PMC9516185/ http://dx.doi.org/10.1093/mmy/myac072.P264 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Oral Presentations Rai, Madhu Patel, Medical Priyanka Rodriguez, Camilla Basu, Shaoli Salvi, Asmita Agrawal, Umang Sunavala, Ayesha Soman, Rajiv Shetty, Anjali P264 Brain phaeohyphomycosis secondary to immunosuppressant therapy due to Rhinocladiella mackenziei |
title | P264 Brain phaeohyphomycosis secondary to immunosuppressant therapy due to Rhinocladiella mackenziei |
title_full | P264 Brain phaeohyphomycosis secondary to immunosuppressant therapy due to Rhinocladiella mackenziei |
title_fullStr | P264 Brain phaeohyphomycosis secondary to immunosuppressant therapy due to Rhinocladiella mackenziei |
title_full_unstemmed | P264 Brain phaeohyphomycosis secondary to immunosuppressant therapy due to Rhinocladiella mackenziei |
title_short | P264 Brain phaeohyphomycosis secondary to immunosuppressant therapy due to Rhinocladiella mackenziei |
title_sort | p264 brain phaeohyphomycosis secondary to immunosuppressant therapy due to rhinocladiella mackenziei |
topic | Oral Presentations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9516185/ http://dx.doi.org/10.1093/mmy/myac072.P264 |
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