Fusarium species causing eumycetoma: Report of two cases and comprehensive review of the literature

Recently, mycetoma was added to the World Health Organization's list of neglected tropical disease priorities. Fusarium as a genus has been reported to cause eumycetoma, but little is known about the species involved in this infection and their identification. In this study, molecular tools were applied to identify Fusarium agents from human eumycetoma cases. The partial translation elongation factor 1‐alpha (TEF‐1α) gene was used as diagnostic parameter. Two additional cases of eumycetoma, due to F. keratoplasticum and F. pseudensiforme, respectively, are presented. A systematic literature review was performed to assess general features, identification, treatment and outcome of eumycetoma infections due to Fusarium species. Of the 20 reviewed patients, the majority (75%) were male. Most agents belonged to the F. solani species complex, ie F. keratoplasticum, F. pseudensiforme, and an undescribed lineage of F. solani. In addition, F. thapsinum, a member of Fusarium fujikuroi species complex was encountered. The main antifungal drugs used were itraconazole, ketoconazole and amphotericin B, but cure rates were low (15%). Partial response or relapse was observed in some cases, and a case ended in amputation. Clinical management of eumycetoma due to Fusarium is complex and combination therapy might be required to increase cure rates.

[1]  M. Mujica,et al.  Micetoma podal por fusarium solani (Mart.) Appel & Wollenweber , 2019, Boletín Micológico.

[2]  D. Geiser,et al.  Epitypification of Fusisporium (Fusarium) solani and its assignment to a common phylogenetic species in the Fusarium solani species complex , 2016, Mycologia.

[3]  J. Meis,et al.  Fusarium: Molecular Diversity and Intrinsic Drug Resistance , 2016, PLoS pathogens.

[4]  J. Meis,et al.  In vitro combinations of natamycin with voriconazole, itraconazole and micafungin against clinical Fusarium strains causing keratitis. , 2016, The Journal of antimicrobial chemotherapy.

[5]  J. Meis,et al.  DNA barcoding, MALDI-TOF, and AFLP data support Fusarium ficicrescens as a distinct species within the Fusarium fujikuroi species complex. , 2016, Fungal biology.

[6]  G. S. de Hoog,et al.  Evaluation of two novel barcodes for species recognition of opportunistic pathogens in Fusarium. , 2016, Fungal biology.

[7]  M. Ghannoum,et al.  International Evaluation of MIC Distributions and Epidemiological Cutoff Value (ECV) Definitions for Fusarium Species Identified by Molecular Methods for the CLSI Broth Microdilution Method , 2015, Antimicrobial Agents and Chemotherapy.

[8]  G. Jouvion,et al.  Seventeen years of subcutaneous infection by Aspergillus flavus; eumycetoma confirmed by immunohistochemistry , 2015, Mycoses.

[9]  A. Fahal,et al.  Eumycetoma and actinomycetoma – an update on causative agents, epidemiology, pathogenesis, diagnostics and therapy , 2015, Journal of the European Academy of Dermatology and Venereology : JEADV.

[10]  S. Mufti,et al.  Mycetoma at a tertiary care hospital in Saudi Arabia: correlation of histopathological and clinical findings , 2015 .

[11]  G. S. de Hoog,et al.  In vitro antifungal susceptibility of coelomycete agents of black grain eumycetoma to eight antifungals. , 2015, Medical mycology.

[12]  A. Fahal,et al.  Mycetoma in the Sudan: An Update from the Mycetoma Research Centre, University of Khartoum, Sudan , 2015, PLoS neglected tropical diseases.

[13]  J. Meis,et al.  Specific antifungal susceptibility profiles of opportunists in the Fusarium fujikuroi complex. , 2014, The Journal of antimicrobial chemotherapy.

[14]  J. Meis,et al.  Keratitis by Fusarium temperatum, a novel opportunist , 2014, BMC Infectious Diseases.

[15]  M. Oddy,et al.  An unusual cause of an ankle mass , 2014, BMJ Case Reports.

[16]  L. Zakaria,et al.  Morphological and Phylogenetic Analysis of Fusarium solani Species Complex in Malaysia , 2014, Microbial Ecology.

[17]  D. Stevens,et al.  Revision of agents of black-grain eumycetoma in the order Pleosporales , 2014, Persoonia.

[18]  A. Bonifaz,et al.  Mycetoma: Experience of 482 Cases in a Single Center in Mexico , 2014, PLoS neglected tropical diseases.

[19]  L. Pagano,et al.  ESCMID and ECMM joint guidelines on diagnosis and management of hyalohyphomycosis: Fusarium spp., Scedosporium spp. and others. , 2014, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[20]  Koichiro Tamura,et al.  MEGA6: Molecular Evolutionary Genetics Analysis version 6.0. , 2013, Molecular biology and evolution.

[21]  W. Sande.  Global burden of human mycetoma: a systematic review and meta-analysis. , 2013 .

[22]  W. V. D. van de Sande.  Global Burden of Human Mycetoma: A Systematic Review and Meta-analysis , 2013, PLoS neglected tropical diseases.

[23]  R. Arenas-Guzmán,et al.  Fusarium subglutinans: A new eumycetoma agent , 2013, Medical mycology case reports.

[24]  Mohan H Kudur,et al.  Fusarium Solani Causing Quasi-Invasive Infection of the Foot in an Immunocompetent Middle-Aged Man from South India , 2013, Indian journal of dermatology.

[25]  G. S. de Hoog,et al.  Pleurostomophora ochracea, a Novel Agent of Human Eumycetoma with Yellow Grains , 2012, Journal of Clinical Microbiology.

[26]  Antonio Di Pietro,et al.  The Top 10 fungal pathogens in molecular plant pathology. , 2012, Molecular plant pathology.

[27]  J. Pemán,et al.  Antifungal Susceptibility Testing of Filamentous Fungi , 2012, Current Fungal Infection Reports.

[28]  M. Dratwa,et al.  Madura’s foot in a renal transplant patient: report of a case , 2011, NDT plus.

[29]  Shen Hong,et al.  Eumycetoma due to Acremonium falciforme acquired in China , 2011, Mycoses.

[30]  A. Kurhade,et al.  FUSARIUM SOLONI MYCETOMA , 2011, Indian journal of dermatology.

[31]  J. Salas-Coronas,et al.  [Mycetoma caused by Fusarium solani]. , 2011, Revista clinica espanola.

[32]  D. Geiser,et al.  Internet-Accessible DNA Sequence Database for Identifying Fusaria from Human and Animal Infections , 2010, Journal of Clinical Microbiology.

[33]  L. Castro,et al.  Clinical and mycologic findings and therapeutic outcome of 27 mycetoma patients from São Paulo, Brazil , 2008, International journal of dermatology.

[34]  A. van Belkum,et al.  Mycetoma caused by Madurella mycetomatis: a neglected infectious burden. , 2004, The Lancet. Infectious diseases.

[35]  Izabela Makalowska,et al.  FUSARIUM-ID v. 1.0: A DNA Sequence Database for Identifying Fusarium , 2004, European Journal of Plant Pathology.

[36]  D. Mercuţ,et al.  [Madura's foot (mycetoma)]. , 2003, Chirurgia.

[37]  J. Dupouy-Camet,et al.  Mycetoma of the Foot Caused by Fusarium solani: Identification of the Etiologic Agent by DNA Sequencing , 2003, Journal of Clinical Microbiology.

[38]  S. Bandyopadhyay,et al.  Epidemiological aspects of mycetoma from a retrospective study of 264 cases in West Bengal , 2002, Tropical medicine & international health : TM & IH.

[39]  L. Sirota,et al.  Mycetoma of the renal pelvis caused by Fusarium species. , 2001, The Pediatric Infectious Disease Journal.

[40]  E. L. Smith,et al.  Improvement of eumycetoma with itraconazole. , 1997, Journal of the American Academy of Dermatology.

[41]  G. Fernandez-Zeppenfeldt,et al.  [Mycetoma: report of 3 cases in Falcón State, Venezuela]. , 1996, Investigacion clinica.

[42]  Klokke Ah.  [Mycetoma of the foot; a diseases from the tropics]. , 1993 .

[43]  W. Belda,et al.  Mycetoma: a retrospective study of 41 cases seen in São Paulo, Brazil, from 1978 to 1989 , 1993, Mycoses.

[44]  L. Ajello,et al.  Fusarium moniliforme, a new mycetoma agent restudy of a European case , 1985, European Journal of Epidemiology.

[45]  M. Thianprasit,et al.  Black Dot Mycetoma , 1984, Mykosen.

[46]  L. Peterson,et al.  Acremonium falciforme (Cephalosporium falciforme) mycetoma in a renal transplant patient. , 1983, Archives of dermatology.

[47]  P. Destombes,et al.  [Mycetomas in the Republic of Somalia]. , 1966, Comptes rendus hebdomadaires des seances de l'Academie des sciences. Serie D: Sciences naturelles.

[48]  A. Gamet,et al.  [New cases of mycetoma detected in Cameroun]. , 1964, Bulletin de la Societe de pathologie exotique et de ses filiales.

[49]  S. Ibrahim.  New insights into a disfiguring fungal disease, eumycetoma , 2016 .

[50]  V. Maheshwari,et al.  Histological Diagnosis of Madura Foot (Mycetoma): A Must for Definitive Treatment , 2009, Journal of global infectious diseases.

[51]  Clinical,et al.  Reference method for broth dilution antifungal susceptibility testing of filamentous fungi : Approved standard , 2008 .

[52]  H. Yamashita,et al.  Mycetoma caused by Fusarium solani with osteolytic lesions on the hand: case report , 2004, Mycopathologia.

[53]  M. T. Hampton.  Atlas of Clinical Fungi , 1997 .

[54]  A. Klokke.  [Mycetoma of the foot; a diseases from the tropics]. , 1993, Nederlands tijdschrift voor geneeskunde.

[55]  L. Castro.  Diagnostic problems with imported cases of mycetoma in The Netherlands. , 1993, Mycoses.

[56]  L. Borradori,et al.  Mycetoma of the foot due to Fusarium sp. treated with oral ketoconazole. , 1992, Dermatology.

[57]  R. Hay,et al.  The histopathological features of pale grain eumycetoma. , 1982, Transactions of the Royal Society of Tropical Medicine and Hygiene.