Exophiala jeanselmei
Exophiala jeanselmei | |
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Scientific classification | |
Domain: | Eukaryota |
Kingdom: | Fungi |
Division: | Ascomycota |
Class: | Eurotiomycetes |
Order: | Chaetothyriales |
Family: | Herpotrichiellaceae |
Genus: | Exophiala |
Species: | E. jeanselmei
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Binomial name | |
Exophiala jeanselmei (Langeron) McGinnis & A.A.Padhye (1977)
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Synonyms[4] | |
Exophiala jeanselmei is a
History
Exophiala jeanselmei was first isolated in 1928 by Jeanselme from a case of black mycetoma on the foot.[7] The nomenclature was based on the fungus' morphological characteristics, hence, it was originally classified as Torula jeanselmei because of its yeast like shape when grown in culture.[7] It was later reclassified by McGinnis and Padhye in 1977 as Exophiala jeanselmei after further research on conidiogenesis.[4][7]
Morphology
In culture, E. jeanselmei produces slow growing colonies that are green black in color. Cultures manifest a combination of mycelial and yeast-like growth forms, however the yeast-like typically predominates.[5][7][8] Black aerial mycelium develops on the colony surface that consists of hyphae with swellings at regular intervals.[7] Conidia are variable in size and are often formed in clusters at the tip of annellidic conidiogenous cells. The conidia are narrowly ellipsoidal in shape and 2.6–5.9 µm × 1.2–2.5 µm in size.[7][8][9] Immature sexual fruiting bodies called ascomata have been reported but their rare occurrence are thought to be due to the lack of mating compatibility.[10] Exophiala jeanselmei is affiliated with the ascomycete genus Capronia.[10]
Ecology
Exophiala jeanselmei is commonly found in soil, plants, water, and can also be isolated from decaying wood as this fungus is a
Pathogenesis
Exophiala jeanselmei has versatile adaptability and acts as an opportunistic pathogen.[7] Infections are more common in immunocompromised people and can also have manifestations in healthy people with wounded skin via traumatic implantation.[5][15] Chronic steroid use has been found to increase the severity of inflammation.[16] There were also cases where infections by E. jeanselmei occurred during solid organ transplants.[17] Infections frequently cause inflammation in the cutaneous and subcutaneous tissues of the skin,[8][15] causing phaeomycotic cyst,[14] chromoblastomycosis[11] and can occasionally cause eumycetoma which is a chronic granulomatous disease in the form of black grains.[15][18] Mycetoma, a common form of clinical manifestation of E. jeanselmei, is a chronic granulomatous inflammatory disease that forms abscess and draining sinuses in more advanced stages.[6] In mycotic mycetoma, vesicles of cyst like structures are formed.[7] Dissemination, endocarditis and arthritis could arise from an opportunistic infection by E. jeanselmei,[6] and it was also isolated from phaeohyphomycosis with sclerotic round bodies.[7] There have been several cases of E. jeanselmei being the etiological agent of phaeohyphomycosis in domesticated cats where diagnoses were confirmed by sequencing the fungus' ribosomal RNA.[19] The grains of this fungus are small, black in color and have soft centers.[7][15] Rare cases of keratitis, infection of the cornea, have also identified E. jeanselmei as the etiological agent.[16]
In vitro susceptibility and treatment
The minimum inhibitory concentration (MIC) of fluconazole for E. jeanselmei is very high, flucytosine and miconazole also have relatively high MICs which indicate that the fungus is fairly resistant to these drugs.[5] Amphotericin B, ketoconazole, and voriconazole have lower MICs, and E. jeanselmei is most susceptible to itraconazole and terbinafine.[5] Novel drugs such as echinocandin and caspofungin also have favorable antifungal activity against Exophiala jeanselmei isolates.[5] However, in vitro susceptibility in comparison to the efficacy of antifungal agents in clinical manifestations of this fungus is currently unknown, that in vitro success may or may not directly correlate clinically.[5]
Previous cases of black grain mycetoma caused by E. jeanselmei were clinically treated and cases of phaeohyphomycosis caused by this fungus were completely cured where both cases were remedied by administering itraconazole.[20][21] E. jeanselmei also showed some susceptibility to being treated with antifungal agents such as amphotericin B, voriconazole and posaconazole.[6] Amphotericin B used to be the most potent antifungal treatment for severe fungal infections, but due to its strong association with severe side effects such as nephrotoxicity, its use is now often replaced with azoles and echinocandins.[6] The use of combinations of surgical excision and pharmacological treatments for severe infections is usually the preferred way to treat diseases caused by this fungus.[5]
References
- .
- ^ Dodge, C.W. (1935). Medical Mycology. Fungous diseases of men and other mammals. The C.V. Mosby company, St. Louis.
- ^ Emmons, C.W. (1945). "Phialophora jeanselmei comb. n. from mycetoma of the hand". Archives of Pathology. 39: 364–368.
- ^ a b c "Exophiala jeanselmei". MycoBank. International Mycological Association.
- ^ a b c d e f g h i "Exophiala spp". Doctor Fungus. Archived from the original on 2015-03-01. Retrieved 2015-03-15.
- ^ ISBN 9789070351809.
- ^ ISBN 0-7216-7586-7.
- ^ a b c d e Ellis, David. "Exophiala jeanselmei". University of Adelaide Mycology Online. Archived from the original on 11 August 2014. Retrieved 7 October 2014.
- ^ ISBN 9070351439.
- ^ S2CID 40143620.
- ^ ISBN 9781588298225.
- PMID 23152554.
- PMID 21944212.
- ^ ISBN 9780030142734.
- ^ ISBN 3-456-81557-3.
- ^ S2CID 205659737.
- S2CID 2769688.
- PMID 7997796.
- PMID 19122414.
- ^ Severo, L.C.; Oliveira, F.M.; Vettorato, G; Londero, A.T. (1999). "Mycetoma caused by Exophiala". Rev Iberoam Micol. 16: 57–59.
- S2CID 32262010.