Invasive pulmonary infection by Syncephalastrum species: Two case reports and review of literature.

Autor:	Irshad M; Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan., Nasir N; Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan., Hashmi UH; Department of Heme-oncology, Aga Khan University Hospital, Karachi, Pakistan., Farooqi J; Department of Microbiology, Aga Khan University Hospital, Karachi, Pakistan., Mahmood SF; Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan.
Jazyk:	angličtina
Zdroj:	IDCases [IDCases] 2020 Jul 25; Vol. 21, pp. e00913. Date of Electronic Publication: 2020 Jul 25 (Print Publication: 2020).
DOI:	10.1016/j.idcr.2020.e00913
Abstrakt:	Background: Syncephalastrum species belong to the class Zygomycetes and order Mucorale. These are found in the environment and tropical soil, usually presenting as colonizers and rarely cause human infection. Syncephalastrum racemosum is a species of the genus Syncephalastrum and is the most commonly identified pathogen. Most cases are reported in immunocompromised individuals, such as patients on long term steroids, poorly controlled diabetes, or patients with malignancy. Case Presentation: We are describing two cases of rare fungal infection by Syncephalastrum species causing invasive pulmonary manifestation. Both patients had compromised immune status and presented with worsening dyspnea to the emergency room. Both had signs and symptoms of bilateral worsening pneumonia evident by chest X-ray showing bilateral pulmonary infiltrates. Syncephalastrum species were isolated from sputum cultures. Deoxycholate amphotericin B was started and the response was monitored. One patient expired while the other improved. Syncephalastrum species belong to class Mucormycosis, rarely causing invasive infection but when they do outcome is potentially fatal. Very few cases are reported worldwide so the clinical course is still unclear. To the best of our knowledge, these are the first two cases to be reported from Pakistan. Conclusions: These two cases describe pneumonia as a result of concomitant infection by rare fungal species Syncephalastrum and MRSA in immunocompromised patients. Few cases are reported so limited data is available to understand complete disease implications. Mucormycosis is a therapeutic challenge because of the phylogenetic diversity, un-availability of any serological testing and invasive disease pattern. Competing Interests: No conflicts of interest (© 2020 The Authors. Published by Elsevier Ltd.)
Databáze:	MEDLINE
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