Two cases of Schizophyllum asthma: Is this a new clinical entity or a precursor of ABPM?

Background: There is a close link between fungal sensitization and asthma severity. Although Schizophyllum commune (S. commune, "suehirotake" in Japanese), one of the basidiomycetous (BM) fungi, is a fungus that can cause allergic bronchopulmonary mycosis (ABPM) and allergic fungal sinusitis (AFS), whether the fungus causes or sensitizes subjects to asthma is unclear. Methods: The bronchial provocation test using S. commune antigen was performed in two asthmatics who had demonstrated positive skin reactions to the S. commune antigen, and low dose of itraconazole (50 mg/day) was prescribed as an adjunctive therapy for 2 weeks. The allergological features and clinical manifestations of these patients are herein evaluated and discussed. Results: Case 1 was a 71-year-old female, and case 2 was a 69-year-old male. Both patients demonstrated positive reactions to the inhalation test. A diagnosis of AFS or ABPM was excluded in both patients because of the lack of a history of pulmonary infiltrates, central bronchiectasis, a history of expectoration of brown plugs or flecks, or sinusoidal findings. Although the efficacy of itraconazole in our cases was unclear, the elevated titer of the specific IgG-for S. commune in case 2 gradually decreased during the period of antifungal therapy. Conclusions: The two patients described herein were diagnosed to have bronchial asthma caused by S. commune; so-called Schizophyllum asthma. S. commune may also be a causative fungal antigen of bronchial asthma. © 2011 Elsevier Ltd. All rights reserved

The Influence of Schizophyllum commune on Asthma Severity

Background: The sensitization and exposure to fungal allergens have been reported to be associated with asthma. The aim of this study was to clarify the impact of sensitization to Schizophyllum commune (S. commune) on the severity and exacerbations of asthma. Methods: Ninety-two patients with asthma of various levels of severity [mild (n = 18), moderate (28), and severe (46)] and exacerbation severity [moderate (n = 43) and severe (6)] were retrospectively examined with regard to fungal sensitization such as specific IgE or intradermal skin reactions against S. commune and other common allergens. We also classified the patients into three groups: (1) three or more asthma attacks during the past year (F-BA) (n = 29),(2) one or two asthma attacks (NF-BA) (n = 20), and (3) no asthma attack (C-BA) (n = 43). Results: The positive rate of late cutaneous reactions to S. commune was higher in patients with severe asthma (41.2%) than with moderate (26.1%) or mild asthma (6.7%), and was significantly different among the three groups (P < 0.05). Although the ratio did not show a significant difference between the patients with severe (83.3%) or moderate (36.1%) exacerbation, it was higher in F-BA (60.9%) than in NF-BA (21.1%) and C-BA patients (10.0%), and it was significantly different among the three groups (P = 0.0002). Multivariate analysis identified positive results for late-phase skin reactions to S. commune and the age of the patients as an independent determinant of asthma severity, and the skin results and %FVC an independent determinant of exacerbation frequency. Conclusion: This study demonstrated that S. commune is an environmental fungus that appears to enhance both the severity of asthma and the exacerbation frequency. © 2011 Springer Science+Business Media, LLC

Case report: First isolation of Exophiala dermatitidis from subcutaneous phaeohyphomycosis in a cat

Phaeohyphomycosis, which is caused by the opportunistic black yeast-like fungus Exophiala dermatitidis, has been reported in humans and dogs. However, no previous studies describing E. dermatitidis infections in cats have been published. Herein, we report a case of subcutaneous phaeohyphomycosis caused by E. dermatitidis. A 12-year-old, castrated male Japanese domestic short-haired cat presented with a solitary subcutaneous abscess on the left side of the neck, where an esophageal tube for force-feeding had been placed previously. The cat was diagnosed with hepatitis and was treated with prednisolone. The subcutaneous abscess was incised using a scalpel blade and the pus was excreted. The cytology of the pus revealed hyphae with neutrophil and macrophage infiltration. Although the cat was treated with oral itraconazole or an infusion of topical ketoconazole cream applied to the lesion, it died. The fungal culture of the pus specimen developed dark-green, waxy, smooth, yeast-like colonies. Sequencing of the internal transcribed spacer 1–4 regions of the ribosomal DNA of the pus specimen showed 100% identity with that of the standard strains of E. dermatitidis. Based on these results, the cat was diagnosed with subcutaneous phaeohyphomycosis caused by E. dermatitidis. The antifungal susceptibility test revealed that the fungus showed low or moderate susceptibility to the antifungal drugs examined, except for amphotericin B, which exhibited high in vitro antifungal activity. This is the first case report to provide definitive evidence of E. dermatitidis infection in cats and antifungal susceptibility test results against clinically isolated E. dermatitidis

Isolation and molecular characterization of clinical and environmental dematiaceous fungi and relatives from Iran

Background and Purpose: The frequency and genetic diversity of black fungi in environmental and clinical settings have not been fully studied in Iran. This study aimed to identify and evaluate intra- and inter-species DNA sequence variation and also understand the phylogenetic relationships of melanized fungi and relatives isolated from different geographical regions of Iran.Materials and Methods: In total, 111 clinical and environmental strains of dematiaceous fungi were isolated, and their internal transcribed spacer ribosomal DNA(rDNA) regions were sequenced and analyzed.Results: An inter-species nucleotide sequence diversity rate of 1 to 464 nucleotides was observed between the species. Intra-species differences were found in the strains of Alternaria alternata, Cladosporium cladosporioides, Alternaria tenuissima, Curvularia spicifera, Aureobasidium pullulans, Curvularia hawaiiensis, Neoscytalidium dimidiatum,Alternaria terricola, Alternaria chlamydospora, Didymella glomerata, and Drechslera dematioidea by 0–59, 0–22, 0–4, 0–4, 0–3, 0–2, 0–2, 0–2, 0–2, 0–1, and 0–1 nt, respectively.Conclusion: The internal transcribed spacer rDNA is useful for the discrimination of several taxa of dematiaceous fungi. However, a better understanding of the taxonomy of species of Alternaria requires a larger rDNA region or a library of other gene sequences

多剤耐性カンジダおよび細菌に対するカスポファンギンの新たな抗微生物活性

長崎大学学位論文 [学位記番号]博（医歯薬）甲第1326号 [学位授与年月日]令和3年3月22