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Mycopathologia (2013) 176:417421 DOI 10.1007/s11046-013-9700-x
Acremonium kiliense: Case Report and Review of Published Studies
Milton Camplesi Jnior Adriano de Moraes Arantes
Hildene Meneses Silva Carolina Rodrigues Costa
Maria do Rosrio Rodrigues Silva
Received: 17 April 2013 / Accepted: 17 August 2013 / Published online: 4 September 2013 Springer Science+Business Media Dordrecht 2013
Abstract Changes in the spectrum of clinically important fungal infection have been observed in recent years. Acremonium species has been responsible for eumycotic mycetomas but has also been increasingly implicated in systemic fungal diseases. A case of Acremonium kiliense fungemia with proven involvement of the lungs in an allogeneic hematopoietic stem cell patient is reported. A high-resolution computed tomography scan of the lungs showed nodules in both lungs. Multiple cultures of blood demonstrated narrow septate hyphae, cylindrical conidia, and solitary tapering phialides and microconidia that remained grouped in slimy heads. The isolate was identied as A. kiliense based on its morphological characteristics and DNA sequence analysis. Susceptibility testing of the clinical isolate was performed to four antifungal agents. Amphotericin B, uconazole and itraconazole were found to be inactive in vitro against the isolate; however, it was found to be sensitive to voriconazole. This last drug
was indicated, and a high-resolution computed tomography scan of the lungs was normal after 10 days. One year later, the patient was free of symptoms and her blood culture was negative for fungi. Thus, voriconazole was effective in treatment for life-threateningA. kiliense infections. In this work, we performed an overview of worldwide clinical infections caused byA. kiliense.
Keywords Acremonium kiliense
Hematopoietic stem cell transplant
Voriconazole
M. C. JniorUniversidade Paulista-UNIP de Gois, Goinia, Brazil
A. de Moraes ArantesHospital Araujo JorgeAssociao de Combate ao Cncer do Estado de Gois, Goinia, Brazil
H. M. Silva C. R. Costa M. R. R. Silva (&)
Instituto de Patologia Tropical e Sade Pblica da Universidade Federal de Goias-UFG, Goinia, GO 74605-050, Brazile-mail: [email protected]
Introduction
Invasive infections caused by opportunistic yeasts and molds are a signicant cause of morbidity and mortality in severely immunocompromised hosts [1 3]. These infections have compromised the success of treatment in bone marrow transplant recipient [4, 5]. Acremonium spp., a saprophytic hyaline mold ubiquitous in the human environment, have emerged as an opportunistic pathogen [613]. The optimal treatment strategy for...