Revista iberoamericana de micologia · 2012
Phenotypic and molecular identification of Coccidioides posadasii in a patient evaluated for bilateral lung transplantation.
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Fernandez Analía, Landaburu Fernanda, Lopez-Daneri Gabriela, Nagel Claudia, Di Giorgio Patricia, Iovannitti Cristina, Tokumoto Marta, Mujica Maria Teresa
Аннотация
BACKGROUND: Coccidioidomycosis is an endemic fungal infection caused by Coccidioides immitis and Coccidioides posadasii. It can be particularly severe in transplant recipients that have a current or a previous coccidioidal infection. Fatal case of coccidioidomycosis has been described in this group of patients.
AIMS: We report a severe case of pneumonia caused by C. posadassi in a 29 year-old white woman that had been admitted to hospital as part of the evaluation for bilateral lung transplantation. The patient was a native and resident of Catamarca, Argentina. Molecular methodologies contributed to the species identification.
METHODS: Clinical, laboratory records and microbiological tests were carried out to diagnose the infection and to identify C. posadasii.
RESULTS: A fungus was isolated from BAL culture. Phenotypic characterization, specific PCR and experimental animal inoculation demonstrated the presence of C. posadasii. The patient responded well to amphotericin B deoxycholate. Lung transplantation was postponed.
CONCLUSIONS: Specific PCR can be an important alternative for the correct identification of C. immitis or C. posadasii in laboratories with implemented molecular biology tools. This case emphasizes the need for a systematic assessment in organ transplant units of patients inhabiting endemic areas of coccidioidomycosis.
AIMS: We report a severe case of pneumonia caused by C. posadassi in a 29 year-old white woman that had been admitted to hospital as part of the evaluation for bilateral lung transplantation. The patient was a native and resident of Catamarca, Argentina. Molecular methodologies contributed to the species identification.
METHODS: Clinical, laboratory records and microbiological tests were carried out to diagnose the infection and to identify C. posadasii.
RESULTS: A fungus was isolated from BAL culture. Phenotypic characterization, specific PCR and experimental animal inoculation demonstrated the presence of C. posadasii. The patient responded well to amphotericin B deoxycholate. Lung transplantation was postponed.
CONCLUSIONS: Specific PCR can be an important alternative for the correct identification of C. immitis or C. posadasii in laboratories with implemented molecular biology tools. This case emphasizes the need for a systematic assessment in organ transplant units of patients inhabiting endemic areas of coccidioidomycosis.