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Pictomicrograph showing Scopulariopsis species (KOH ×10 × ×40 magnification) having basipetal globose to pyriform conidia on annellides (solitary and in groups)
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Fungal infection of the paranasal sinuses is an increasingly recognized entity, both in normal and immunocompromised individuals. The recent increase in mycotic nasal and paranasal infections is due to both improved diagnostic research and an increase in the conditions that favor fungal infection. Although fungal infections of the paranasal sinus a...
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Fungal infections of the paranasal sinuses may occur in patients with chronic sinusitis, who usually have a predisposing cause such as neutropenia, prolonged use of corticosteroids, uncontrolled diabetes mellitus, HIV infection. Occasionally it may also be seen in immunocompetent patients. The patient's medical report and occupation seem to be very...
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... At present, Coniosporium, Cyphellophora, Fonsecaea, Phialophora Exophiala, Rhinocladiella and Cladophialophora species are the most clinically relevant dematiaceous fungi worldwide [3]. Phaeohyphomycosis represents a broad range of primary and opportunistic mycoses [4] includes superficial, cutaneous, systemic, and dissemination [5]. Paranasal sinus phaeohyphomycosis is a rare infection [6], and immunocompromised state is not a pre-requisite [7] as observed in our patient [4]. ...
... Phaeohyphomycosis represents a broad range of primary and opportunistic mycoses [4] includes superficial, cutaneous, systemic, and dissemination [5]. Paranasal sinus phaeohyphomycosis is a rare infection [6], and immunocompromised state is not a pre-requisite [7] as observed in our patient [4]. From the present case study, we highlight that any patient with subcutaneous swelling in the cheek with CT finding of erosion of sinus we should consider dermatophyseal fungal infection as one of the differential diagnosis in an immunocompetent patient with no other risk factors(Diabetes mellitus/hypertension/ immunosuppressant therapy etc). ...
... At present, Coniosporium, Cyphellophora, Fonsecaea, Phialophora Exophiala, Rhinocladiella and Cladophialophora species are the most clinically relevant dematiaceous fungi worldwide [3]. Phaeohyphomycosis represents a broad range of primary and opportunistic mycoses [4] includes superficial, cutaneous, systemic, and dissemination [5]. Paranasal sinus phaeohyphomycosis is a rare infection [6], and immunocompromised state is not a pre-requisite [7] as observed in our patient [4]. ...
... Phaeohyphomycosis represents a broad range of primary and opportunistic mycoses [4] includes superficial, cutaneous, systemic, and dissemination [5]. Paranasal sinus phaeohyphomycosis is a rare infection [6], and immunocompromised state is not a pre-requisite [7] as observed in our patient [4]. From the present case study, we highlight that any patient with subcutaneous swelling in the cheek with CT finding of erosion of sinus we should consider dermatophyseal fungal infection as one of the differential diagnosis in an immunocompetent patient with no other risk factors(Diabetes mellitus/hypertension/ immunosuppressant therapy etc). ...
... A total of 10 cases of sinonasal infections by species of Scopulariopsis have been reported; 12,13,16,27,39,[85][86][87][88][89] however, three of the cases were doubtful, as in two of them two different fungi were present in the lesions. Specifically, in one of these doubtful cases, a lesion in the left maxillary sinus was reported to be due to Scopulariopsis. ...
... However, apart from this fungus, Paecilomyces sp. was also isolated from the lesion. 89 In another, case reported by Aznar et al., 16 M. cinereus and Aspergillus repens were concomitantly present in the lesions. In the third doubtful case, 88 which consisted of a pediatric invasive sinonasal infection, the images displayed in the paper are more compatible with a mucormycosis, which shows similar clinical features and usually responds to treatment by liposomal amphotericin B and surgical debridement, as occurred in this case. ...
Scopulariopsis is a common fungus in the environment, characterized by its intrinsic resistance to the available antifungal drugs. Around 70 cases of infection by this fungus have been described in the literature. Pulmonary and disseminated infections are the most common and their treatment is difficult; therefore, very diverse approaches have been taken, with varied results. A successful outcome has been reported in only a few cases, generally attributed to a multitreatment strategy combining medical and surgical procedures that ultimately led to the resection of the infected tissue if possible, identification of the mould, and an aggressive long-term antifungal therapy. Although most of the infections are caused by Scopulariopsis brevicaulis, a few other species have also been linked to these cases, although molecular evidence has not been proven for all of them. On this basis, more knowledge on the epidemiology, presentation, diagnosis, treatment, and prognosis of these unusual infections would improve their management. This review aims to compile the current data on Scopulariopsis infections.
... Mucor and aspergillus species are the most common causative agents of fungal sinusitis, but infection with lesser known species have been reported across the world infrequently. [11] Inflammatory sinus disease such as chronic sinusitis with granulation tissue accumulation may also produce the same signs and symptoms such as nasal stuffiness and a mass related enlargement of the maxilla. Mycotic infection of the upper respiratory tract are usually located in the paranasal sinuses. ...
... This is a slowly destructive process that most commonly affects the ethmoid and sphenoid sinuses but may involve any paranasal sinus. [4][5][6] Paecilomyces is a cosmopolitan filamentous fungus that inhabits the soil, decaying plants, and food products. Paecilomyces is usually considered as a contaminant but may also cause infections in humans and animals as a superficial or invasive infection. ...
Fungal infection of the paranasal sinuses is an increasingly recognised entity, both in normal and immunocompromised individuals. The recent increase in mycotic nasal and paranasal infections is due to both improved diagnostic research and an increase in the conditions that favour fungal infection. Aspergillus, Candida, and Mucor species are the most common causative agents of fungal sinusitis, but infection with lesser known species have been reported across the world infrequently. This article reviews and presents a case report of chronic fungal sinusitis in an immunocompetent adult male infected with Paecilomyces variotii which is opportunistic soil saprophyte, uncommon to humans. © 2016 Indian Journal of Medical Microbiology Published by Wolters Kluwer - Medknow.
... W literaturze medycznej można znaleźć opisy przypadków zakażeń Scopulariopsis dotyczące m.in. następujących lokalizacji: rogówki [51], wnętrza gałki ocznej [5], siatkówki i naczyniówki [79], ucha [9], zatok [28], jamy szczękowej [67], przegrody nosowej [39], mózgu [33], płuc [72], oskrzeli [89], wsierdzia [42], a także grzybic rozsianych [85]. ...
The genus Scopulariopsis accommodates more than 30 species of mitosporic moulds. Their natural habitat is the soil, where they live as saprophytes and are involved in the decomposition of organic matter. However, some members of the Scopulariopsis genus may cause opportunistic infections in humans. Superficial skin lesions and onychomycosis in particular are the most predominant clinical manifestations. Much rarer are subcutaneous, deep tissue and disseminated infections, most of which occur in immunocompromised individuals and are associated with high mortality. Treatment of Scopulariopsis infections is difficult and usually empirically-based, one reason for this being resistance of Scopulariopsis spp. to a broad spectrum of antifungal agents. Identification of pathogenic Scopulariopsis spp. still largely relies on the phenotype-based methods, employing both morphological and biochemical criteria. These methods require highly qualified personnel and are usually considered as slow and laborious, often leading to misidentification. Therefore, molecular diagnostic methods are preferred, since they provide rapid, high-throughout, unambiguous and highly specific identification of fungal pathogens. Earlier attempts to develop assays for detecting Scopulariopsis spp. resulted in limited success. These assays, almost exclusively based on the hypervariable regions of the large subunit (LSU) rRNA, often produce inconclusive results and, more importantly, lack specificity, being unable to discriminate between different Scopulariopsis spp. Hence, currently available molecular methods do not allow inter- and intra-species differentiation of Scopulariopsis fungi.
Dientamoeba fragilis is now considered a potentially emerging gastrointestinal pathogen in both developing and developed countries. We first report an autochthonous case of D. fragilis infection in Greece. A 49-year-old female with acute non-specific abdominal pain required emergency surgical admission for active observation and repeated assessment. To the best of our knowledge, this is the first reported case of acute unexplained abdominal pain finally attributed to D. fragilis infection using microscopic and molecular methods. © 2016 Indian Journal of Medical Microbiology Published by Wolters Kluwer - Medknow.
The maxillary sinus may be involved in a wide variety of disorders. Many of these share common presenting symptoms but some have unique features. This article reviews some of the recent publications in this area.
The majority of isolated maxillary sinus disease has been previously described. Some recent data on the microbiology of sinusitis have been published. The review also highlights the growing role of endoscopic surgical management due to improved instrumentations and techniques.
On the basis of the review, diagnosing isolated maxillary sinus disease can still be delayed due to late presentation. When suspected, it is advisable to investigate early with computed tomography scanning and proceeding to MRI if needed. Often these will show certain features with clues to the diagnosis. Final diagnosis is frequently only obtained on histological examination. The majority of these disorders can now be managed by endoscopic techniques alone with open surgery required in a small number of cases.
