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Published in: Current Fungal Infection Reports 4/2019

01-12-2019 | Itraconazole | Fungal Infections of Skin and Subcutaneous Tissue (A Bonifaz and M Pereira, Section Editors)

Chromoblastomycosis in Solid Organ Transplant Recipients

Authors: Raaka Kumbhakar, Benjamin A. Miko

Published in: Current Fungal Infection Reports | Issue 4/2019

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Abstract

Purpose of review

There is growing recognition of melanized fungi as uncommon but important causes of infection among solid organ transplant recipients. Chromoblastomycosis and phaeohyphomycosis exist at opposing ends of the spectrum of disease caused by these fungi. We aim to systematically review the reports of chromoblastomycosis among transplant recipients to assess for trends in epidemiology and clinical outcomes.

Recent Findings

We identified 19 reported cases of histologically confirmed chromoblastomycosis among solid organ transplant recipients published between 1985 and 2018. Despite these patients’ impaired immunity, chromoblastomycosis remained localized to the skin and subcutaneous tissue in the majority of patients. Clinical outcomes were generally good with medical, surgical, or combined management.

Summary

Although chromoblastomycosis has a low incidence in this population, it is important to consider as a cause of chronic, non-healing skin infections. Further research is needed to better elucidate the impact of transplantation on the natural course of this condition.
Literature
2.
go back to reference Terra MF, Torres M, Fonseca FO, Esteban-Torres M, Fonseca O, Area Leao AE. Novo typo de dermatite verrucosa micose por acrotheca com associacao de leishmaniose. Brasil-Med. 1922;2:363–8.CrossRef Terra MF, Torres M, Fonseca FO, Esteban-Torres M, Fonseca O, Area Leao AE. Novo typo de dermatite verrucosa micose por acrotheca com associacao de leishmaniose. Brasil-Med. 1922;2:363–8.CrossRef
3.
go back to reference Moore M, Almeida F. Etiologic agents of chromomycosis (chromoblastomycosis of Terra, Torres, Fonseca and Leao, 1922) of North and South America. Rev Biol Hyg. 1935;6:94–7. Moore M, Almeida F. Etiologic agents of chromomycosis (chromoblastomycosis of Terra, Torres, Fonseca and Leao, 1922) of North and South America. Rev Biol Hyg. 1935;6:94–7.
4.
go back to reference •• Queiroz-Telles F, de Hoog S, Santos DW, Salgado CG, Vicente VA, Bonifaz A, et al. Chromoblastomycosis. Clin Microbiol Rev. 2017;30:233–76. https://doi.org/10.1128/CMR.00032-16An extensive systematic review of chromoblastomycosis focusing on its microbiology, epidemiology, pathogenesis, clinical manifestations, and treatment. CrossRefPubMed •• Queiroz-Telles F, de Hoog S, Santos DW, Salgado CG, Vicente VA, Bonifaz A, et al. Chromoblastomycosis. Clin Microbiol Rev. 2017;30:233–76. https://​doi.​org/​10.​1128/​CMR.​00032-16An extensive systematic review of chromoblastomycosis focusing on its microbiology, epidemiology, pathogenesis, clinical manifestations, and treatment. CrossRefPubMed
9.
go back to reference Gezuele E, Mackinnon JE, Conti-Díaz IA. The frequent isolation of Phialophora verrucosa and Phialophora pedrosoi from natural sources. Sabouraudia. 1972;10:266–73.CrossRef Gezuele E, Mackinnon JE, Conti-Díaz IA. The frequent isolation of Phialophora verrucosa and Phialophora pedrosoi from natural sources. Sabouraudia. 1972;10:266–73.CrossRef
10.
go back to reference Vicente AP, Attili DA, Queiroz-Telles F, Pizzirani-Kleiner AP. Isolation of herpotrichiellacious fungi from the environment. Braz J Microbiol. 2001;32:47–51.CrossRef Vicente AP, Attili DA, Queiroz-Telles F, Pizzirani-Kleiner AP. Isolation of herpotrichiellacious fungi from the environment. Braz J Microbiol. 2001;32:47–51.CrossRef
12.
go back to reference Marques SG, Silva Cde M, Saldanha PC, Rezende MA, Vicente VA, Queiroz-Telles F, et al. Isolation of Fonsecaea pedrosoi from the shell of the babassu coconut (Orbignya phalerata Martius) in the Amazon region of Maranhão Brazil. Nihon Ishinkin Gakkai Zasshi. 2006;47:305–11.CrossRef Marques SG, Silva Cde M, Saldanha PC, Rezende MA, Vicente VA, Queiroz-Telles F, et al. Isolation of Fonsecaea pedrosoi from the shell of the babassu coconut (Orbignya phalerata Martius) in the Amazon region of Maranhão Brazil. Nihon Ishinkin Gakkai Zasshi. 2006;47:305–11.CrossRef
13.
go back to reference Queiroz-Telles F, Santos DWC, Pedroso C. Fungal infections of implantation (chromoblastomycosis, mycetoma, entomophthoramycosis, and lacaziosis). In: Hospenthal D, Rinaldi MG, editors. Diagnosis and treatment of fungal infections. 2nd ed. Basel: Springer International Publishing; 2015. https://doi.org/10.1007/978-3-319-13090-3.CrossRef Queiroz-Telles F, Santos DWC, Pedroso C. Fungal infections of implantation (chromoblastomycosis, mycetoma, entomophthoramycosis, and lacaziosis). In: Hospenthal D, Rinaldi MG, editors. Diagnosis and treatment of fungal infections. 2nd ed. Basel: Springer International Publishing; 2015. https://​doi.​org/​10.​1007/​978-3-319-13090-3.CrossRef
16.
go back to reference Navarrete MR, Arenas R, Estrada VFM, Diéguez CEA, Mayorga J, Bonifaz A, et al. Cromoblastomicosis en México. Revisión de 603 casos en siete décadas. Dermatologia CMQ. 2014;12:87–93. Navarrete MR, Arenas R, Estrada VFM, Diéguez CEA, Mayorga J, Bonifaz A, et al. Cromoblastomicosis en México. Revisión de 603 casos en siete décadas. Dermatologia CMQ. 2014;12:87–93.
17.
go back to reference Lavelle P. Chromomycosis. In: Canizares O, editor. Clinical tropical dermatology. London: Blackwell Science; 1975. Lavelle P. Chromomycosis. In: Canizares O, editor. Clinical tropical dermatology. London: Blackwell Science; 1975.
18.
go back to reference Álvarez-Montiel I, Bonifaz AA. Cromoblastomicosis en placa superficial. Manifestación de una variante poco habitual. Dermatol Rev Mex. 2014;58:529–33. Álvarez-Montiel I, Bonifaz AA. Cromoblastomicosis en placa superficial. Manifestación de una variante poco habitual. Dermatol Rev Mex. 2014;58:529–33.
19.
go back to reference Ramírez O. Cromoblastomicosis en El Salvador. Arch Col Med El Salv. 1956;9:218–23.PubMed Ramírez O. Cromoblastomicosis en El Salvador. Arch Col Med El Salv. 1956;9:218–23.PubMed
25.
go back to reference Battu V, Ramam M, Pasricha JS, Mohapatra LN. Chromomycosis with some unusual features. Indian J Dermatol Venereol Leprol. 1986;52:181–3.PubMed Battu V, Ramam M, Pasricha JS, Mohapatra LN. Chromomycosis with some unusual features. Indian J Dermatol Venereol Leprol. 1986;52:181–3.PubMed
27.
29.
go back to reference Hube B. Extracellular proteinases of human pathogenic fungi. Contrib Microbiol. 2000;5:126–37.CrossRef Hube B. Extracellular proteinases of human pathogenic fungi. Contrib Microbiol. 2000;5:126–37.CrossRef
31.
go back to reference Kneipp LF, Palmeira VF, Pinheiro AA, Alviano CS, Rozental S, Travassos LR, et al. Phosphatase activity on the cell wall of Fonsecaea pedrosoi. Med Mycol. 2003;41:469–77.CrossRef Kneipp LF, Palmeira VF, Pinheiro AA, Alviano CS, Rozental S, Travassos LR, et al. Phosphatase activity on the cell wall of Fonsecaea pedrosoi. Med Mycol. 2003;41:469–77.CrossRef
32.
go back to reference Schnadig VJ, Woods GL. Histopathology of fungal infections. In: Anaissie EJ, McGinnis MR, Pfaller MA, editors. Clinical Mycology. London: Churchill Livingstone; 2009. Schnadig VJ, Woods GL. Histopathology of fungal infections. In: Anaissie EJ, McGinnis MR, Pfaller MA, editors. Clinical Mycology. London: Churchill Livingstone; 2009.
35.
go back to reference • Tourret J, Willing BP, Dion S, MacPherson J, Denamur E, Finlay BB. Immunosuppressive treatment alters secretion of ileal antimicrobial peptides and gut microbiota, and favors subsequent colonization by uropathogenic Escherichia coli. Transplantation. 2017;101:74–82. https://doi.org/10.1097/TP.0000000000001492An interesting study that evaluates the gut microbiome in mice receiving immunosuppression and characterizes disruptions in microbiota community structure and defines alterations in innate immune responses. CrossRefPubMed • Tourret J, Willing BP, Dion S, MacPherson J, Denamur E, Finlay BB. Immunosuppressive treatment alters secretion of ileal antimicrobial peptides and gut microbiota, and favors subsequent colonization by uropathogenic Escherichia coli. Transplantation. 2017;101:74–82. https://​doi.​org/​10.​1097/​TP.​0000000000001492​An interesting study that evaluates the gut microbiome in mice receiving immunosuppression and characterizes disruptions in microbiota community structure and defines alterations in innate immune responses. CrossRefPubMed
42.
go back to reference Kinkead S, Jancic V, Stasko T, Boyd AS. Chromoblastomycosis in a patient with a cardiac transplant. Cutis. 1996;58:367–70.PubMed Kinkead S, Jancic V, Stasko T, Boyd AS. Chromoblastomycosis in a patient with a cardiac transplant. Cutis. 1996;58:367–70.PubMed
44.
go back to reference •• Ogawa MM, Peternelli MP, Enokihara MM, Nishikaku AS, Gonçalves SS, Tomimori J. Spectral manifestation of melanized fungal infections in kidney transplant recipients: report of six cases. Mycopathologia. 2016;181:379–85. https://doi.org/10.1007/s11046-016-0005-8The largest case series specifically focused on chromoblastomycosis (rather than phaeohyphomycosis) in solid organ transplant recipients. CrossRefPubMed •• Ogawa MM, Peternelli MP, Enokihara MM, Nishikaku AS, Gonçalves SS, Tomimori J. Spectral manifestation of melanized fungal infections in kidney transplant recipients: report of six cases. Mycopathologia. 2016;181:379–85. https://​doi.​org/​10.​1007/​s11046-016-0005-8The largest case series specifically focused on chromoblastomycosis (rather than phaeohyphomycosis) in solid organ transplant recipients. CrossRefPubMed
45.
go back to reference Peña-Penabad C, Durán MT, Yebra MT, Rodríguez-Lozano J, Vieira V, Fonseca E. Chromomycosis due to Exophiala jeanselmei in a renal transplant recipient. Eur J Dermatol. 2003;13:305–7.PubMed Peña-Penabad C, Durán MT, Yebra MT, Rodríguez-Lozano J, Vieira V, Fonseca E. Chromomycosis due to Exophiala jeanselmei in a renal transplant recipient. Eur J Dermatol. 2003;13:305–7.PubMed
46.
go back to reference Redondo-Bellón P, Idoate M, Rubio M, Ignacio HJ. Chromoblastomycosis produced by Aureobasidium pullulans in an immunosuppressed patient. Arch Dermatol. 1997;133:663–4.CrossRef Redondo-Bellón P, Idoate M, Rubio M, Ignacio HJ. Chromoblastomycosis produced by Aureobasidium pullulans in an immunosuppressed patient. Arch Dermatol. 1997;133:663–4.CrossRef
47.
go back to reference Sideris ER, Ge L. Chromoblastomycosis in immunosuppressed patients. Med J Aust. 2018;209:295.CrossRef Sideris ER, Ge L. Chromoblastomycosis in immunosuppressed patients. Med J Aust. 2018;209:295.CrossRef
49.
go back to reference Verma P, Karmakar S, Pandhi D, Singal A, Yadav P, Khare S. Chromoblastomycosis caused by Cladophialophora bantiana in a renal transplant recipient from Delhi, India. Skinmed. 2015;13:251–4.PubMed Verma P, Karmakar S, Pandhi D, Singal A, Yadav P, Khare S. Chromoblastomycosis caused by Cladophialophora bantiana in a renal transplant recipient from Delhi, India. Skinmed. 2015;13:251–4.PubMed
50.
go back to reference Wackym PA, Gray GF Jr, Richie RE, Gregg CR. Cutaneous chromomycosis in renal transplant recipients. Successful management in two cases. Arch Intern Med. 1985;145:1036–7.CrossRef Wackym PA, Gray GF Jr, Richie RE, Gregg CR. Cutaneous chromomycosis in renal transplant recipients. Successful management in two cases. Arch Intern Med. 1985;145:1036–7.CrossRef
51.
go back to reference •• Santos DW, Camargo LF, Gonçalves SS, Ogawa MM, Tomimori J, Enokihara MM, et al. Melanized fungal infections in kidney transplant recipients: contributions to optimize clinical management. Clin Microbiol Infect. 2017;23:333.e9–333.e14. https://doi.org/10.1016/j.cmi.2016.12.024A comprehensive retrospective observational study examining the spectrum of melanized fungal infections, including phaeohyphomycosis and chromoblastomycosis, among kidney transplant recipients. CrossRef •• Santos DW, Camargo LF, Gonçalves SS, Ogawa MM, Tomimori J, Enokihara MM, et al. Melanized fungal infections in kidney transplant recipients: contributions to optimize clinical management. Clin Microbiol Infect. 2017;23:333.e9–333.e14. https://​doi.​org/​10.​1016/​j.​cmi.​2016.​12.​024A comprehensive retrospective observational study examining the spectrum of melanized fungal infections, including phaeohyphomycosis and chromoblastomycosis, among kidney transplant recipients. CrossRef
Metadata
Title
Chromoblastomycosis in Solid Organ Transplant Recipients
Authors
Raaka Kumbhakar
Benjamin A. Miko
Publication date
01-12-2019
Publisher
Springer US
Published in
Current Fungal Infection Reports / Issue 4/2019
Print ISSN: 1936-3761
Electronic ISSN: 1936-377X
DOI
https://doi.org/10.1007/s12281-019-00351-9

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