科研之友
微信
新浪微博
Facebook
分享链接
摘要
BackgroundThe genus emmonsia contains three species that are associated with human disease. Emmonsia crescens and Emmonsia parva are the agents that cause adiaspiromycosis, and one human case of Emmonsia pasteuriana infection has been described. We report a fungal pathogen within the genus emmonsia that is most closely related to E. pasteuriana in human immunodeficiency virus (HIV)-infected adults in South Africa. %26lt;br%26gt;MethodsBetween July 2008 and July 2011, we conducted enhanced surveillance to identify the cause of systemic, dimorphic fungal infections in patients presenting to Groote Schuur Hospital and other hospitals affiliated with the University of Cape Town, Cape Town, South Africa. DNA sequencing was used to identify pathogenic fungi. %26lt;br%26gt;ResultsA total of 24 cases of dimorphic fungal infection were diagnosed, 13 of which were caused by an emmonsia species. All 13 patients were HIV-infected, with a median CD4+ T-cell count of 16 cells per cubic millimeter (interquartile range, 10 to 44), and all had evidence of disseminated fungal disease. Three patients died soon after presentation, but the others had a good response to a variety of antifungal agents and antiretroviral therapy. Phylogenetic analysis of five genes (LSU, ITS1-2, and the genes encoding actin, -tubulin, and intein PRP8) revealed that this fungus belongs in the genus emmonsia and is most closely related to E. pasteuriana. %26lt;br%26gt;ConclusionsThe findings suggest that these isolates of an emmonsia species represent a new species of dimorphic fungus that is pathogenic to humans. The species appears to be an important cause of infections in Cape Town. %26lt;br%26gt;In the context of immunologic failure associated with advanced HIV infection, a novel dimorphic fungus in the genus emmonsia is identified as an important cause of human disease. This report describes 13 cases of infection with this organism in Cape Town, South Africa. The human immunodeficiency virus (HIV) pandemic in sub-Saharan Africa has resulted in an epidemic of opportunistic fungal diseases, some of which are caused by new and emerging fungal pathogens.(1) Much remains to be learned about the endemic fungi of sub-Saharan Africa. For example, considerable differences have been noted between the African and North American varieties of Histoplasma capsulatum and Blastomyces dermatitidis.(2) The genus emmonsia contains three species associated with human disease. Emmonsia crescens and Emmonsia parva are the agents of adiaspiromycosis, a pulmonary disease of small mammals and occasionally of humans.(3)Emmonsia pasteuriana infection has been described in a ...
- 出版日期2013-10-10
