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Published in: BMC Infectious Diseases 1/2017

Open Access 01-12-2017 | Case report

Unique case report of a chromomycosis and Listeria in soft tissue and cerebellar abscesses after kidney transplantation

Authors: J. Tourret, N. Benabdellah, S. Drouin, F. Charlotte, J. Rottembourg, N. Arzouk, A. Fekkar, B. Barrou

Published in: BMC Infectious Diseases | Issue 1/2017

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Abstract

Background

Chromomycosis is a rare mycotic infection encountered in tropical and subtropical regions. The disease presents as a slowly-evolving nodule that can become infected with bacteria. Here, we describe a unique association of abscesses caused by a chromomycosis and Listeria monocytogenes in a kidney transplant recipient, and didactically expose how the appropriate diagnosis was reached.

Case presentation

A 49-year old male originating from the Caribbean presented a scalp lesion which was surgically removed in his hometown where it was misdiagnosed as a sporotrichosis on histology, 3 years after he received a kidney transplant. He received no additional treatment and the scalp lesion healed. One year later, an abscess of each thigh due to both F. pedrosoi and L. monocytogenes was diagnosed in our institution. A contemporary asymptomatic cerebellar abscess was also found by systematic MRI. An association of amoxicillin and posaconazole allowed a complete cure of the patient without recurring to surgery. Histological slides from the scalp lesion were re-examined in our institution and we retrospectively concluded to a first localisation of the chromomycosis. We discuss the possible pathophysiology of this very unusual association.

Conclusion

In this case of disseminated listeriosis and chromomycosis, complete cure of the patients could be reached with oral anti-infectious treatment only.
Literature
1.
go back to reference De Hoog GS, Queiroz-Telles F, Haase G, Fernandez-Zeppenfeldt G, Attili Angelis D, Gerrits Van Den Ende AH, Matos T, Peltroche-Llacsahuanga H, Pizzirani-Kleiner AA, Rainer J, et al. Black fungi: clinical and pathogenic approaches. Med Mycol. 2000;38(Suppl 1):243–50.CrossRefPubMed De Hoog GS, Queiroz-Telles F, Haase G, Fernandez-Zeppenfeldt G, Attili Angelis D, Gerrits Van Den Ende AH, Matos T, Peltroche-Llacsahuanga H, Pizzirani-Kleiner AA, Rainer J, et al. Black fungi: clinical and pathogenic approaches. Med Mycol. 2000;38(Suppl 1):243–50.CrossRefPubMed
2.
3.
go back to reference Queiroz-Telles F, Esterre P, Perez-Blanco M, Vitale RG, Salgado CG, Bonifaz A. Chromoblastomycosis: an overview of clinical manifestations, diagnosis and treatment. Med Mycol. 2009;47(1):3–15.CrossRefPubMed Queiroz-Telles F, Esterre P, Perez-Blanco M, Vitale RG, Salgado CG, Bonifaz A. Chromoblastomycosis: an overview of clinical manifestations, diagnosis and treatment. Med Mycol. 2009;47(1):3–15.CrossRefPubMed
4.
go back to reference Aldape KD, Fox HS, Roberts JP, Ascher NL, Lake JR, Rowley HA. Cladosporium trichoides cerebral phaeohyphomycosis in a liver transplant recipient. Report of a case. Am J Clin Pathol. 1991;95(4):499–502.CrossRefPubMed Aldape KD, Fox HS, Roberts JP, Ascher NL, Lake JR, Rowley HA. Cladosporium trichoides cerebral phaeohyphomycosis in a liver transplant recipient. Report of a case. Am J Clin Pathol. 1991;95(4):499–502.CrossRefPubMed
5.
go back to reference Mancini MC, McGinnis MR. Dactylaria infection of a human being: pulmonary disease in a heart transplant recipient. J Heart Lung Transplant. 1992;11(4 Pt 1):827–30.PubMed Mancini MC, McGinnis MR. Dactylaria infection of a human being: pulmonary disease in a heart transplant recipient. J Heart Lung Transplant. 1992;11(4 Pt 1):827–30.PubMed
6.
go back to reference Padhye AA, Hampton AA, Hampton MT, Hutton NW, Prevost-Smith E, Davis MS. Chromoblastomycosis caused by Exophiala spinifera. Clin Infect Dis. 1996;22(2):331–5.CrossRefPubMed Padhye AA, Hampton AA, Hampton MT, Hutton NW, Prevost-Smith E, Davis MS. Chromoblastomycosis caused by Exophiala spinifera. Clin Infect Dis. 1996;22(2):331–5.CrossRefPubMed
7.
go back to reference Rossmann SN, Cernoch PL, Davis JR. Dematiaceous fungi are an increasing cause of human disease. Clin Infect Dis. 1996;22(1):73–80.CrossRefPubMed Rossmann SN, Cernoch PL, Davis JR. Dematiaceous fungi are an increasing cause of human disease. Clin Infect Dis. 1996;22(1):73–80.CrossRefPubMed
8.
go back to reference Sughayer M, DeGirolami PC, Khettry U, Korzeniowski D, Grumney A, Pasarell L, McGinnis MR. Human infection caused by Exophiala pisciphila: case report and review. Rev Infect Dis. 1991;13(3):379–82.CrossRefPubMed Sughayer M, DeGirolami PC, Khettry U, Korzeniowski D, Grumney A, Pasarell L, McGinnis MR. Human infection caused by Exophiala pisciphila: case report and review. Rev Infect Dis. 1991;13(3):379–82.CrossRefPubMed
9.
go back to reference Patel U, Chu J, Patel R, Meehan S. Subcutaneous dematiaceous fungal infection. Dermatol Online J. 2011;17(10):19.PubMed Patel U, Chu J, Patel R, Meehan S. Subcutaneous dematiaceous fungal infection. Dermatol Online J. 2011;17(10):19.PubMed
10.
go back to reference Lupi O, Tyring SK, McGinnis MR. Tropical dermatology: fungal tropical diseases. J Am Acad Dermatol. 2005;53(6):931–51. quiz 952-934CrossRefPubMed Lupi O, Tyring SK, McGinnis MR. Tropical dermatology: fungal tropical diseases. J Am Acad Dermatol. 2005;53(6):931–51. quiz 952-934CrossRefPubMed
11.
go back to reference Brandt ME, Warnock DW. Epidemiology, clinical manifestations, and therapy of infections caused by dematiaceous fungi. J Chemother. 2003;15(Suppl 2):36–47.CrossRefPubMed Brandt ME, Warnock DW. Epidemiology, clinical manifestations, and therapy of infections caused by dematiaceous fungi. J Chemother. 2003;15(Suppl 2):36–47.CrossRefPubMed
12.
go back to reference Minotto R, Bernardi CD, Mallmann LF, Edelweiss MI, Scroferneker ML. Chromoblastomycosis: a review of 100 cases in the state of Rio Grande do Sul, Brazil. J Am Acad Dermatol. 2001;44(4):585–92.CrossRefPubMed Minotto R, Bernardi CD, Mallmann LF, Edelweiss MI, Scroferneker ML. Chromoblastomycosis: a review of 100 cases in the state of Rio Grande do Sul, Brazil. J Am Acad Dermatol. 2001;44(4):585–92.CrossRefPubMed
13.
go back to reference Torres-Guerrero E, Isa-Isa R, Isa M, Arenas R. Chromoblastomycosis. Clin Dermatol. 2012;30(4):403–8.CrossRefPubMed Torres-Guerrero E, Isa-Isa R, Isa M, Arenas R. Chromoblastomycosis. Clin Dermatol. 2012;30(4):403–8.CrossRefPubMed
14.
go back to reference Alviano CS, Travassos LR, Schauer R. Sialic acids in fungi: a minireview. Glycoconj J. 1999;16(9):545–54.CrossRefPubMed Alviano CS, Travassos LR, Schauer R. Sialic acids in fungi: a minireview. Glycoconj J. 1999;16(9):545–54.CrossRefPubMed
15.
go back to reference Alviano DS, Franzen AJ, Travassos LR, Holandino C, Rozental S, Ejzemberg R, Alviano CS, Rodrigues ML. Melanin from Fonsecaea pedrosoi induces production of human antifungal antibodies and enhances the antimicrobial efficacy of phagocytes. Infect Immun. 2004;72(1):229–37.CrossRefPubMedPubMedCentral Alviano DS, Franzen AJ, Travassos LR, Holandino C, Rozental S, Ejzemberg R, Alviano CS, Rodrigues ML. Melanin from Fonsecaea pedrosoi induces production of human antifungal antibodies and enhances the antimicrobial efficacy of phagocytes. Infect Immun. 2004;72(1):229–37.CrossRefPubMedPubMedCentral
17.
go back to reference Zhang JM, Xi LY, Zhang H, Xie Z, Sun JF, Li XQ, Lu S. Synergistic effects of terbinafine and itraconazole on clinical isolates of Fonsecaea monophora. Eur J Dermatol. 2009;19(5):451–5.PubMed Zhang JM, Xi LY, Zhang H, Xie Z, Sun JF, Li XQ, Lu S. Synergistic effects of terbinafine and itraconazole on clinical isolates of Fonsecaea monophora. Eur J Dermatol. 2009;19(5):451–5.PubMed
18.
go back to reference Castro LG, Pimentel ER, Lacaz CS. Treatment of chromomycosis by cryosurgery with liquid nitrogen: 15 years' experience. Int J Dermatol. 2003;42(5):408–12.CrossRefPubMed Castro LG, Pimentel ER, Lacaz CS. Treatment of chromomycosis by cryosurgery with liquid nitrogen: 15 years' experience. Int J Dermatol. 2003;42(5):408–12.CrossRefPubMed
19.
go back to reference Sousa Mda G, Reid DM, Schweighoffer E, Tybulewicz V, Ruland J, Langhorne J, Yamasaki S, Taylor PR, Almeida SR, Brown GD. Restoration of pattern recognition receptor costimulation to treat chromoblastomycosis, a chronic fungal infection of the skin. Cell Host Microbe. 2011;9(5):436–43.CrossRefPubMed Sousa Mda G, Reid DM, Schweighoffer E, Tybulewicz V, Ruland J, Langhorne J, Yamasaki S, Taylor PR, Almeida SR, Brown GD. Restoration of pattern recognition receptor costimulation to treat chromoblastomycosis, a chronic fungal infection of the skin. Cell Host Microbe. 2011;9(5):436–43.CrossRefPubMed
20.
go back to reference Wevers BA, Kaptein TM, Zijlstra-Willems EM, Theelen B, Boekhout T, Geijtenbeek TB, Gringhuis SI. Fungal engagement of the C-type lectin mincle suppresses dectin-1-induced antifungal immunity. Cell Host Microbe. 2014;15(4):494–505.CrossRefPubMed Wevers BA, Kaptein TM, Zijlstra-Willems EM, Theelen B, Boekhout T, Geijtenbeek TB, Gringhuis SI. Fungal engagement of the C-type lectin mincle suppresses dectin-1-induced antifungal immunity. Cell Host Microbe. 2014;15(4):494–505.CrossRefPubMed
21.
go back to reference Tourret J, Willing BP, Dion S, Macpherson AJ, Denamur E, Finlay B. Immunosuppressive treatment alters secretion of ileal antimicrobial peptides and gut microbiota, and favors subsequent colonization by uropathogenic Escherichia coli. Transplantation 2016, In press. Tourret J, Willing BP, Dion S, Macpherson AJ, Denamur E, Finlay B. Immunosuppressive treatment alters secretion of ileal antimicrobial peptides and gut microbiota, and favors subsequent colonization by uropathogenic Escherichia coli. Transplantation 2016, In press.
22.
go back to reference Imbert S, Bresler P, Boissonnas A, Gauthier L, Souchet L, Uzunov M, Leblond V, Mazier D, Nguyen S, Fekkar A. Calcineurin inhibitors impair neutrophil activity against Aspergillus fumigatus in allogeneic hematopoietic stem cell transplant recipients. J Allergy Clin Immunol. 2016;138(3):860–8.CrossRefPubMed Imbert S, Bresler P, Boissonnas A, Gauthier L, Souchet L, Uzunov M, Leblond V, Mazier D, Nguyen S, Fekkar A. Calcineurin inhibitors impair neutrophil activity against Aspergillus fumigatus in allogeneic hematopoietic stem cell transplant recipients. J Allergy Clin Immunol. 2016;138(3):860–8.CrossRefPubMed
23.
24.
go back to reference Azevedo CD, Bruna-Romero O, Marques SG, Nascimento FR, Pinto MC, Silva LA, Bouillet LE, Azevedo FS, Stoianoff MA. Association of IgG immunoglobulin and subclasses level with the severity of chromoblastomycosis due to Fonsecaea pedrosoi and therapeutic response to itraconazole. Eur J Clin Microbiol Infect Dis. 2014;33(10):1791–7.CrossRefPubMed Azevedo CD, Bruna-Romero O, Marques SG, Nascimento FR, Pinto MC, Silva LA, Bouillet LE, Azevedo FS, Stoianoff MA. Association of IgG immunoglobulin and subclasses level with the severity of chromoblastomycosis due to Fonsecaea pedrosoi and therapeutic response to itraconazole. Eur J Clin Microbiol Infect Dis. 2014;33(10):1791–7.CrossRefPubMed
25.
go back to reference Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM. Foodborne illness acquired in the United States--major pathogens. Emerg Infect Dis. 2011;17(1):7–15.CrossRefPubMedPubMedCentral Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM. Foodborne illness acquired in the United States--major pathogens. Emerg Infect Dis. 2011;17(1):7–15.CrossRefPubMedPubMedCentral
26.
go back to reference Silk BJ, Date KA, Jackson KA, Pouillot R, Holt KG, Graves LM, Ong KL, Hurd S, Meyer R, Marcus R, et al. Invasive listeriosis in the Foodborne Diseases Active Surveillance Network (FoodNet), 2004-2009: further targeted prevention needed for higher-risk groups. Clin Infect Dis. 2012;54(Suppl 5):S396–404.CrossRefPubMed Silk BJ, Date KA, Jackson KA, Pouillot R, Holt KG, Graves LM, Ong KL, Hurd S, Meyer R, Marcus R, et al. Invasive listeriosis in the Foodborne Diseases Active Surveillance Network (FoodNet), 2004-2009: further targeted prevention needed for higher-risk groups. Clin Infect Dis. 2012;54(Suppl 5):S396–404.CrossRefPubMed
27.
go back to reference Tseng J, Strasfeld LM, Orloff SL. An unusual presentation of altered mental status after orthotopic liver transplantation: Listeria brain abscess. Transplantation. 2013;95(12):e72–3.CrossRefPubMed Tseng J, Strasfeld LM, Orloff SL. An unusual presentation of altered mental status after orthotopic liver transplantation: Listeria brain abscess. Transplantation. 2013;95(12):e72–3.CrossRefPubMed
28.
go back to reference Lambotte O, Fihman V, Poyart C, Buzyn A, Berche P, Soumelis V. Listeria monocytogenes skin infection with cerebritis and haemophagocytosis syndrome in a bone marrow transplant recipient. J Infect. 2005;50(4):356–8.CrossRefPubMed Lambotte O, Fihman V, Poyart C, Buzyn A, Berche P, Soumelis V. Listeria monocytogenes skin infection with cerebritis and haemophagocytosis syndrome in a bone marrow transplant recipient. J Infect. 2005;50(4):356–8.CrossRefPubMed
30.
go back to reference Nobrega JP, Rosemberg S, Adami AM, Heins-Vaccari EM, Lacaz Cda S, de Brito T. Fonsecaea pedrosoi cerebral phaeohyphomycosis ("chromoblastomycosis"): first human culture-proven case reported in Brazil. Rev Inst Med Trop Sao Paulo. 2003;45(4):217–20.CrossRefPubMed Nobrega JP, Rosemberg S, Adami AM, Heins-Vaccari EM, Lacaz Cda S, de Brito T. Fonsecaea pedrosoi cerebral phaeohyphomycosis ("chromoblastomycosis"): first human culture-proven case reported in Brazil. Rev Inst Med Trop Sao Paulo. 2003;45(4):217–20.CrossRefPubMed
31.
go back to reference Surash S, Tyagi A, De Hoog GS, Zeng JS, Barton RC, Hobson RP. Cerebral phaeohyphomycosis caused by Fonsecaea monophora. Med Mycol. 2005;43(5):465–72.CrossRefPubMed Surash S, Tyagi A, De Hoog GS, Zeng JS, Barton RC, Hobson RP. Cerebral phaeohyphomycosis caused by Fonsecaea monophora. Med Mycol. 2005;43(5):465–72.CrossRefPubMed
32.
go back to reference Vyas MC, Joshi YR, Bhargava N, Joshi KR, Tanwar RK. Cerebral chromoblastomicosis--a rare case report of cerebral abscess and brief review of literature--a case report. Indian J Pathol Microbiol. 2000;43(1):81–5.PubMed Vyas MC, Joshi YR, Bhargava N, Joshi KR, Tanwar RK. Cerebral chromoblastomicosis--a rare case report of cerebral abscess and brief review of literature--a case report. Indian J Pathol Microbiol. 2000;43(1):81–5.PubMed
Metadata
Title
Unique case report of a chromomycosis and Listeria in soft tissue and cerebellar abscesses after kidney transplantation
Authors
J. Tourret
N. Benabdellah
S. Drouin
F. Charlotte
J. Rottembourg
N. Arzouk
A. Fekkar
B. Barrou
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2017
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-017-2386-9

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