Lo Shih-Hao, Wang Hsin-Hui, Chang Ya-Ting, Lin Chih-Hung, Lu Po-Liang, Lin Shang-Yi
Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Internal Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan.
Mycopathologia. 2023 Oct;188(5):841-843. doi: 10.1007/s11046-023-00786-2. Epub 2023 Sep 2.
Magnusiomyces capitatus is a dimorphic yeast commonly isolated from the environment and was uncommonly reported as a disease in Asia. It may cause invasive infection in patients with hematological malignancies, especially those with neutropenia, and resulting in high mortality. Herein, we reported a man with nasopharyngeal carcinoma and hepatocellular carcinoma suffered from intermittent fever after pulmonary nodules resection. The histopathology showed yeast-like fungal elements. For further identification, we extracted the tissue DNA from formalin-fixed paraffin-embedded tissue and M. capitatus was confirmed using polymerase chain reaction amplification and sequencing of the ITS region of ribosomal DNA. After a 4-week amphotericin B and flucytosine treatment, his condition recovered well and then was followed by a 3-month oral fluconazole treatment. There was no evidence of recurrence within one year. Our case highlights that nucleic acids obtained from formalin-fixed tissue could be a feasible identification method, especially in those whose culture results are unavailable.
头状大奴霉菌是一种常见于从环境中分离出来的二态性酵母,在亚洲作为一种疾病的报道并不常见。它可能导致血液系统恶性肿瘤患者,尤其是中性粒细胞减少患者发生侵袭性感染,并导致高死亡率。在此,我们报告了一名患有鼻咽癌和肝细胞癌的男性,在肺结节切除术后出现间歇性发热。组织病理学显示有酵母样真菌成分。为了进一步鉴定,我们从福尔马林固定石蜡包埋组织中提取组织DNA,并通过核糖体DNA的ITS区域的聚合酶链反应扩增和测序确认了头状大奴霉菌。经过4周的两性霉素B和氟胞嘧啶治疗后,他的病情恢复良好,随后接受了3个月的口服氟康唑治疗。一年内没有复发的迹象。我们的病例强调,从福尔马林固定组织中获得的核酸可能是一种可行的鉴定方法,尤其是在那些无法获得培养结果的情况下。