It gains its importance in being mostly resistant to treatment with amphotericin B. Other treatment options for aspergillosis include itraconazole, caspofungin, or voriconazole in combination with terbinafine. Debridamento cirúrgico e excisão não foram realizados. Other drugs used to treat aspergillosis include itraconazole, amphotericin B, caspofungin, micafungin, and posaconazole. Eine weitere Untersuchung, die einen TRH Stimulationstest beinhaltete, führte zur Diagnose von PPID (Morbus cushing), welcher zur Immunsupprimierung des Tieres und zu einer erhöhten Empfindlichkeit für eine Infektion geführt haben könnte. Fungal culture identified the causative organism as Aspergillus terreus, which is not known for its propensity to cause either dermal granulomas or mycetoma in domestic animals. Surgical debridement or excision was not performed. Treatment options depend on the aspergillosis disease type and severity. C'était aussi la première source pour la mévinoline ( lovastatine ), un médicament utilisé pour abaisser le taux sérique de cholestérol . For years, investigative studies on the failure of therapy of fungal infections have focused on in vitro susceptibility data. Number of times cited according to CrossRef: Guttural pouch diseases in horses: A challenging differential diagnosis. Aspergillus infections may be resistant to clotrimazole and may require the use of oral itraconazole. Aspergillus terreus was isolated from bronchoalveolar lavage (BAL) fluid and its presence was confirmed by sequencing. Aspergillus terreus An emerging amphotericin B–resistant opportunistic mold in patients with hematologic malignancies † Ray Y. Hachem M.D. Until recently, species identification was sufficient to guide antifungal therapy, b… Prolonged treatment is usually required. L'examen cytologique de la masse a révélé une inflammation pyogranulomateuse et l'examen histopathologique a révélé un mycétome fongique. Amphotericin B (AmB) is a first-line antifungal that has been applied in clinics for decades to treat severe fungal infections, like invasive aspergillosis. Aspergillus terreus is an emerging pathogen which commonly occurs in infections of immunocompromised individuals and is associated with high mortality. Des tests supplémentaires comprenant un test de stimulation TRH a mené au diagnostic de PPID (maladie de Cushing) qui peut entrainer une immunosuppression et une augmentation de la susceptibilité aux infections. Mycetoma is a chronic, proliferative lesion of cutaneous/subcutaneous tissue characterized by draining tracts and granules in the discharge caused by actinomycetes (actinomycetoma) or filamentous fungi (eumycotic mycetoma). In contrast to Aspergillus fumigatus, A. terreus infections are associated with high dissemination rates and poor response to antifungal treatment. Mycobacterial infections in equids: Clinical characteristics and diagnostic techniques. It is estimated that up to 10% of people with cystic fibrosis or asthma experience an allergic reaction to aspergillus. Se presentó un caballo macho castrado de 16 años de raza del Fiordo con sospecha de disfunción de la pars intermedia de la pituitaria (PPID) para la evaluación de una masa no dolorosa, firme y elevada que afectaba el ala lateral de la fosa nasal derecha y el labio. It is rarely found in the acidic forest soils from the colder temperate zone. • The use of posaconazole for the treatment of IA by A. terreus is promising. Aspergillus lung infections are fairly common in those with weakened immune systems, such as AIDS and chemotherapy patients. Furthermore, treatment may be complicated by drug toxicity or interactions [2]. A 16‐year‐old Fjord gelding with suspected pituitary pars intermedia dysfunction (PPID) was presented for evaluation of a nonpainful, firm and raised mass involving the lateral wing of the right nostril and the lip. • Voriconazole PK interpatient variability is determined by CYP2C19 polymorphisms. Invasive aspergillosis (IA) is the most common filamentous fungal infection observed in immunocompromised patients [ 1–4 ]. CARACTÉRISTIQUES: Le genre Aspergillus appartient à la classe des Euascomycetes de l’embranchement AscomycotaNote de bas de page 1. From 124 NDM confirmed cultures, 23 were identified as A. terreus (18.5%). Unlike other Aspergillus species causing opportunistic infections in animals and humans commonly, infections caused by A. terreus is increasing more rapidly and has been considered an emerging agent of infection. Lovastatin is a potent 3-hydroxymethylglutaryl-CoA (3-HMG-CoA) inhibitor, discovered in the late 1970s at Merck Research Laboratories in the fermented broth of Aspergillus terreus, used in the treatment of hypercholesterolemia (Alberts et al., 1980; Tobert, 2003). is non-specific but commonly distal-lateral pattern of onychomycosis. Temperature and growth. Aspergillus terreus occurs commonly in soil and is occasionally reported as a pathogen of humans and animals. Le genre Aspergillus est subdivi… 菌腫は、放線菌(放線菌腫)または糸状真菌(真菌性菌腫)によって引き起こされる瘻管および肉芽腫を特徴とする皮膚/皮下組織の慢性の増殖性病変である。, 本症例報告では、フィヨルド・ホースの去勢馬の右鼻孔の外側翼に認められた非一般的な皮膚菌腫の所見を記述する。, 下垂体中間部の機能障害(PPID)が疑われた16歳のフィヨルド・ホースの去勢雄が、右鼻孔の外側翼と口唇を巻き込む、痛みを伴わない、固く隆起した腫瘤の評価のために来院した。, 腫瘤の細胞診検査では顕著な化膿性肉芽腫性の炎症が認められ、病理組織学的検査では真菌性菌腫が明らかになった。真菌の培養検査によって、原因菌はAspergillus terreusと同定された。Aspergillus terreusが家畜の真皮に肉芽腫や菌腫を引き起こすことはこれまで報告されていない。TRH刺激試験を含む更なる検査により、PPID(クッシング病)が診断され、このことが患畜の免疫抑制および易感染性傾向をもたらした可能性がある。, 患馬は経口ヨウ化カリウム、およびPPIDに対してはペルゴリドにて治療され、良好な治療反応を示した。5ヶ月後までに再発は認められなかった。外科的な掻爬や切除は行われなかった。著者らの知る限りでは、これはA. The molecule was first named mevinolin entering the market in 1987 and became a blockbuster, with annual sales of over one billion dollars … The horse was treated medically with pergolide for the PPID and oral potassium iodide for the fungal infection, with good therapeutic response and no relapse after five months. Treatment with itraconazole has variable success. Le traitement est basé sur lemploi de corticostéroïdes par aérosols ou par voie orale, surtout durant les crises. Um equino macho castrado, da raça Fjord com suspeita de disfunção pituitária da pars intermedia (PPID) foi apresentado para avaliação de uma massa firme, elevada e não dolorosa envolvendo a face lateral da narina direita. The most common and successful conventional treatment of aspergillosis is a generic drug called itraconazole, which is a triazole type of anti-fungal. After a 2-week antifungal scheme, the fungus was identified as Aspergillus terreus. To try to understand this poor response to treatment, available data on the in vitro susceptibility of A. terreus, the experimental and clinical response to amphotericin B, triazoles and echinocandins, and the pharmacokinetics/pharmacodynamics of these antifungals have been reviewed. Allergic types of aspergillosis: the antifungal medication itraconazole , … Treatment can last … Computed tomography imaging was done, revealing a 70 cc hematoma in the right operculoinsular region, midline shift, and a 9 mm saccular aneurysm at the bifurcation of the middle cerebral artery. ABPA is estimated to occur … No se realizó debridamiento quirúrgico o excisión. Superficial white onychomycosis was the most frequent clinical pattern. A. flavus or Aspergillus terreus are the most frequent causes of primary infection. We use cookies to help provide and enhance our service and tailor content and ads. can also occur . Aspergillus fumigatusis the major cause of invasive aspergillosis, followed by Aspergillus terreusand Aspergillus flavus. People with weakened immune systems include those people taking chemotherapy or those who have had organ transplants. • Il s’agit d’espèces anamorphes (asexuées) ayant des formes télomorphes connues ou présumées dans la famille des TrichocomaceaeNote de bas de page 1. Valentina Salas, F. Javier Pastor, M. M. Rodríguez, Enrique Calvo, Emilio Mayayo, Josep Guarro, In Vitro Activity and In Vivo Efficacy of Posaconazole in Treatment of Murine Infections by Different Isolates of the Aspergillus terreus Complex , Antimicrobial Agents and Chemotherapy, 10.1128/AAC.00736-10, 55, 2, (676-679), (2010). Further investigation, including a TRH stimulation test, led to a diagnosis of PPID (Cushing's disease), which may have led to immunosuppression of the animal and increased susceptibility to infection. O cavalo foi tratado com pergolida para para a PPID e iodeto de potássio por via oral, com boa resposta terapêutica e sem recidiva após cinco meses. Despite the use of recommended therapies, invasive infections by Aspergillus terreus show a poor response. Positive cultures were obtained in 1639 samples. Exposure to Aspergillus is not likely to cause problems in the majority of people whose immune systems are healthy. Aspergillus terreus is brownish in colour and gets darker as it ages on culture media. Oral antifungal therapy or surgery to remove the nail may be required. Ce cas clinique décrit des données inhabituelles d'un mycétome cutané de l'aile latéral de la narine droite d'un hongre. To the best of the authors’ knowledge, this is the first case report of a cutaneous mycetoma caused by A. terreus in a horse. Investigação posterior, incluindo teste de estimulação por TRH, levou ao diagnóstico de PPID (síndrome de Cushing), que pode ter causado imunossupressão no animal, aumentando a sua suscetibilidade à infecção. On Czapek or malt extract agar (MEA) medium at 25 °C (77 °F), colonies have the conditions to grow rapidly and have smooth-like walls. Invasive aspergillosis (IA) remains a difficult to manage infectious disease. Investigation. However, the incidence of A. terreus infection is increasing more rapidly than any other Aspergillus and for this reason it is considered an emerging agent of infection. In some cases, they are able to become floccose, achieving hair-like soft tufts. Aspergillus terreus tends to have relative resistance to amphotericin B, and outcomes of infection are poor. Low antifungal MICs are not definitive markers of A. terreus susceptibility. The use of posaconazole for the treatment of IA by A. terreus is promising. However, people with chronic lung problems or people with weak immune systems may be at greater risk for developing the infection. A nuestro entender basado en evaluación de la literatura, este es el primer caso de un micetoma cutáneo causado por A. terreus en un caballo. Cytological examination of the mass showed marked pyogranulomatous inflammation and histopathological examination revealed a fungal mycetoma. Primary skin infection can lead to invasive aspergillosis, particularly if the patient is immunocompromised . Mycetoma es una lesión crónica proliferativa de tejido cutáneo/subcutáneo caracterizada por drenajes y gránulos en el exudado causado por actinomicetos (actinomicetoma) u hongos filamentosos (micetoma eumicótico). Corresponding Author. NOM : Aspergillusspp. Many experimental and clinical studies have tried to establish a relationship between MICs and outcome in serious fungal infections but have come to contradictory and even surprising conclusions. Expert guidance is needed for infections not responding to treatment, including antifungal-resistant infections. Die PPID des Pferdes wurde medizinisch erfolgreich mit Pergolid und Kaliumbromid per os behandelt. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, By continuing to browse this site, you agree to its use of cookies as described in our,,, I have read and accept the Wiley Online Library Terms and Conditions of Use. Distinctive featuresVelutinous colonies formed at both 25°C and 37°C, uniformly brown, with no other colouration, and minute conidia borne in long columns make Aspergillus terreus a distinctive species. Copyright © 2020 Elsevier B.V. or its licensors or contributors. Use the link below to share a full-text version of this article with your friends and colleagues. Es bestand eine gute therapeutische Reaktion und kein Wiederauftreten nach fünf Monaten. and you may need to create a new Wiley Online Library account. Learn more. Learn about our remote access options, VetAgro Sup, Veterinary Campus of Lyon, University of Lyon, 69280 Marcy l'Etoile, France, Cabinet Vétérinaire du Vallon, 465 route de la Merlanchonnière, 42740 St Paul en Jarez, France. Este relato de caso descreve um achado raro de um micetoma cutâneo na face lateral da narina direita de um cavalo. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved. Aspergillus terreus isolates were identified through their morphological characteristics and using molecular methods. Fungal culture identified the causative organism as Aspergillus terreus , which is not known for its propensity to cause either dermal granulomas or mycetoma in domestic animals. No growth at 5°C. doit être recherchée chez les patients inscrits sur les listes dattente de transplantation pulmonaire et nécessite un traitement antifongique. The success or failure of treatment is determined by many factors, including the in vitro susceptibility of the causative fungal isolate, the pharmacokinetics/pharmacodynamics of the drug used for treatment, pharmacokinetic variability in the population, and the underlying disease that patients suffer. A total of 2485 samples were obtained. Investigaciones adicionales, incluyendo una prueba de estimulación con TRH, llevaron a un diagnóstico de PPID (enfermedad de Cushing), que podía haber causado inmunosupresión del animal y una susceptibilidad aumentada a la infección.; Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. Dieser Fallbericht beschreibt den ungewöhnlichen Befund eines kutanen Mycetoms am rechten lateralen Nasenflügel eines Wallachs. Systemic antifungal therapy Itraconazole can be used for superficial otitis externa, but any invasion, including perforation of the tympanic membrane should be treated with voriconazole. Please check your email for instructions on resetting your password. The patient developed sudden rostrocaudal deterioration. Working off-campus? Treatment for invasive and cutaneous aspergillosis: When possible, immunosuppressive medications should be discontinued or decreased. Of special interest are the fungistatic activites of these drugs against A. terreus and the high interpatient variability of serum drug levels observed in therapy based on triazoles, which make monitoring of infected patients necessary. Further investigation, including a TRH stimulation test, led to a diagnosis of PPID (Cushing's disease), which may have led to immunosuppression of the animal and increased susceptibility to infection. 5 Voriconazole is the recommended treatment for Aspergillus infection. Recent in vitro and in vivo studies indicate that A. terreus is dis… This case report describes the unusual finding of a cutaneous mycetoma of the lateral wing of the right nostril in a gelding. • Treatment with itraconazole has variable success. What are treatment options for an Aspergillus infection? A la connaissance des auteurs, ceci est le premier cas de mycétome cutané du à A. terreus chez un cheval. If you do not receive an email within 10 minutes, your email address may not be registered, A cultura fúngica identificou Aspergillus terreus como o agente causador. Aspergillus ustus tends to have relatively lower susceptibility to multiple different antifungal agents, and susceptibility testing should be performed for this organism. Antifungal cream or ointment applied to the affected nail is effective in some milder cases. As an opportunistic pathogen, it is able to cause both systemic and superficial infections. Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger , and Aspergillus terreus are the most common species causing IA [ 5 , 6 ], but most studies identify A. fumigatus or A. flavus as the etiological agent in the majority of cases. Nach bestem Wissen der Autoren handelt es sich hierbei um den ersten Fallbericht eines kutanen Mycetoms, welches durch A. terreus bei einem Pferd verursacht worden war. Ein 16 Jahre alter Fjordwallach mit Verdacht auf eine Dysfunktion der Pars intermedia der Hypophyse (PPID) wurde zur Untersuchung einer nicht schmerzhaften, derben und erhabenen Masse, die den lateralen Nasenflügel und die Lippe betraf, vorgestellt. The therapy success in IA by Aspergillus terreus is determined by many factors. The … Aspergillus most commonly enters the human body via inhalation. Le mycétome est une lésion cutanée/sous‐cutanée proliférative et chronique caractérisée par des fistules et des granules causé par des actinomycètes (actinomycetome) ou des champignons filamenteux (mycétome eumycotique). terreus has an inhibitory effect on the growth of dermatophytes and Scopulariopis brevicaulis. However, it is well known that low minimum inhibitory concentrations (MICs) are not always predictive of response to therapy despite a correct dosage schedule. El cultivo fúngico identificó el organismo causal como Aspergillus terreus, que no es conocido por ser propenso a causar granulomas dérmicos o micetomas en animales domésticos. Este artículo describe un caso poco habitual de un micetoma cutáneo en el ala lateral de la fosa nasal derecha en un caballo macho castrado. Exame citológico da massa revelou inflamação piogranulomatosa e a histopatologia revelou um micetoma fúngico. The illnesses resulting from aspergillosis usually affect the respiratory system, but their signs and severity vary greatly.The mold that triggers the illnesses, aspergillus, is everywhere — indoors and outdoors. Morphological Identification: On Czapek Dox agar, colonies are typically suede-like and cinnamon-buff to sand-brown in colour with a yellow to deep dirty brown reverse. Localised cellulitis is usually followed by development of a necrotic ulcer. International Journal of Antimicrobial Agents, Although the outcome of IA is largely determined by the persistence of the underlying disease or immunosuppression, factors related to the fungus also play a role. Onychomycosis due to infection with Aspergillus spp. Die zytologische Untersuchung der Masse zeigte eine deutliche pyogranulomatöse Entzündung und die histopathologische Untersuchung zeigte ein Mycetom. terreusによって引き起こされた馬の皮膚の真菌性菌腫の最初の症例報告である。, 足菌肿是一种皮肤/皮下组织的慢性、增生性病变,以放线菌(放线菌性足菌肿)和丝状真菌(真菌性足菌肿)引起的窦道和带颗粒的分泌物为特征。, 一只疑似患有垂体中间部功能障碍(PPID)的16岁峡湾马,对其右侧鼻孔和嘴唇侧翼上的无痛性、坚实且凸起的团块进行评估。, 团块的细胞学检查结果显示明显的脓性肉芽肿性炎症,组织病理学检查发现真菌性足菌肿病,真菌培养鉴定发现病原微生物为土曲霉。目前,对该菌在家畜上引发真皮肉芽肿或足菌肿的易感性并不清楚。进一步调查包括TRH刺激试验,用于诊断PPID(库兴氏病),该病可能导致动物的免疫抑制并增加感染风险。, 使用培高利特,该马匹的PPID获得成功治疗,同时服用碘化钾,取得良好疗效,五个月之后并无复发。本病例未进行手术清创或切除。根据作者的了解,这是第一例由土曲霉引起的马皮肤足菌肿病例。. ... Voriconazole is currently used as first-line treatment for invasive aspergillosis. RG-2 organism. 3 The duration of antifungal treatment is variable but has been reported to exceed 200 days. Colonies on malt extract agar grow faster and sporulate more densely than on many other media. Aspergillosis is an infection caused by a type of mold. El caballo fue tratado con éxito con pergolida para la PPID y yoduro de potasio oral, con buena respuesta terapéutica y sin recaídas después de cinco meses. De acordo com o conhecimento dos autores, este é o primeiro relato de caso de micetoma cutâneo em equinos causado por A. terreus. Une culture fongique a identifié Aspergillus terreus comme l'organisme responsable bien qu'il ne soit pas reconnu comme pouvant entrainer des granulomes ou des mycétomes chez l'animal domestique. Fax: (713) 792‐8233. Conidial heads are compact, columnar (up to 500 x 30-50 µm in diameter) and biseriate. Le cheval a été traité avec succès médicament pour le PPID avec du pergolide et de l'iodure de potassium avec une bonne réponse thérapeutique et aucune rechute après cinq mois. Sputum and BAL culture yielded Aspergillus ochraceus and Aspergillus terreus, which were both sensitive to itraconazole and voriconazole. Treatment depends on the causative species and the severity of the disease. Case presentation A 26-year-old man with a history of consanguineous par-ents (cousins) was referred with weight loss, fever, hepa-tosplenomegaly and coughing. Aspergillus terreus est une moisissure couramment utilisée dans l'industrie pour produire d'importants acides organiques, tels que l' acide itaconique et l' acide cis-aconitique. Es wurde kein chirurgisches Debridement oder eine Exzision durchgeführt. Aspergillus terreus is not as common as other Aspergillus species to cause opportunistic infections in animals and humans. A negative culture with a positive KOH may point to a NDM including Aspergillus spp., as the causative agent of onychomycosis. The treatment was switched to voriconazole and the patient showed significant clinical, serological and mycological improvement after three months. SYNONYME OR RENVOI: Aspergillose, maladie du poumon de fermier, A. fumigatus, A. flavus, A. niger, A. nidulans, A. terreusNote de bas de page 1. O micetoma é uma lesão cutânea/subcutânea crônica, proliferativa e caracterizada por tratos fistulosos com secreção contendo grânulos, causados por actinomicetos (actinomicetoma) ou fungos filamentosos (micetoma eumicótico). El examen citológico de la masa mostró marcada inflamación piogranulomatosa y el examen histopatológico reveló un micetoma fúngico. The clinical presentation of onychomycosis due to Aspergillus spp. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. By continuing you agree to the use of cookies. Voriconazole PK interpatient variability is determined by CYP2C19 polymorphisms. Das Mycetom ist eine chronische, proliferative Veränderung von kutanem/subkutanem Gewebe, welches durch Fistelgänge und Granula im Ausfluss, die durch Actinomyceten (Actinomycetom) oder filamentöse Pilze (eumykotisches Mycetom) verursacht werden, charakterisiert ist. Aspergillus terreus is a fungus that is widespread throughout the world and found in warm arable soils; and found more commonly in cultivated soils than the forest. Un hongre Fjord de 16 ans suspecté de PPID (pituitary pars intermedia dysfunction) a été présenté pour examen d'une masse alopécique, ferme, non douloureuse évoluant au niveau de l'aile de la narine droite et de la lèvre. The full text of this article hosted at is unavailable due to technical difficulties. Un débridement chirurgical ou une exérèse n'a pas été réalisée. Most people breathe in aspergillus spores every day, with no ill-effect. The therapy success in IA by Aspergillus terreus is determined by many factors. Early diagnosis is often difficult and in up to 50% of cases the etiologic agent is not recovered in culture [1]. Treatment consists of systemic therapy with terbinafine or itraconazole. People with severe cases of aspergillosis may need surgery. Die Pilzkultur identifizierte den verursachenden Organismus als Aspergillus terreus, der nicht bekannt ist für eine Neigung, entweder dermale Granulome oder Mycetome bei Haustieren zu verursachen. Topical treatment with 1% Pimafucin in a mixture of 60% dimethylsulfoxide (DMSO) and 40% water as well as 9% aqueous solution of sodium benzoate were both effective. The frequency of A. terreus infections varies from 3%–12.5% [ 5–9 ]. Un antifongique administré oralement (itraconazole) peut y être associé. Este não é conhecido pela sua probabilidade de causar granulomas dérmicos ou micetomas em animais domésticos. La colonisation bronchique par Aspergillus spp.
2020 aspergillus terreus treatment