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Allergic Fungal Sinusitis Caused by Exserohilum rostratum and Literature Review

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Abstract

A case of allergic fungal sinusitis (AFS) caused by Exserohilum rostratum, proven by culture and histopathology of the biopsy material, is described. The identity of the isolate was confirmed by sequencing of ITS region of rDNA. To the best of our knowledge, this is the first report of allergic E. rostratum sinusitis from Kuwait and Arabian Peninsula. Ten previously described cases of AFS have been reviewed. The report highlights the emerging importance of E. rostratum as a human pathogen in this region and role of molecular methods in its accurate identification.

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References

  1. Adler A, Yaniv I, Samra Z, Yacobovich J, Fisher S, Avrahami G, Levy I. Exserohilum: an emerging human pathogen. Eur J Clin Microbiol Infect Dis. 2006;25:247–53.

    Article  CAS  PubMed  Google Scholar 

  2. De Hoog GS, Guarro J, Gené J, Fígueras MJ. Atlas of clinical fungi, pilot version of. 3rd ed. Baarn: CD-ROM. Centraalbureau voor Schimmelcultures; 2009.

    Google Scholar 

  3. da Cunha KC, Sutton DA, Gené J, Capilla J, Cano J, Guarro J. Molecular identification and in vitro response to antifungal drugs of clinical isolates of Exserohilum. Antimicrob Agents Chemother. 2012;56:4951–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Katragkou A, Pana Z-D, Perlin SD, Kontoyiannis DP, Walsh TJ, Roilides E. Exserohilum infections: review of 48 cases before the 2012 United States outbreak. Med Mycol. 2012;2014(52):376–86.

    Google Scholar 

  5. Khan ZU, Ahmad S, Theyyathel AM. Detection of Aspergillus fumigatus-specific DNA, (1-3)-β -D-glucan and galactomannan in serum and bronchoalveolar lavage specimens of experimentally infected rats. Mycoses. 2008;51:129–35.

    Article  CAS  PubMed  Google Scholar 

  6. Khan ZU, Ahmad S, Al-Ghimlas F, Al-Mutairi S, Joseph L, Chandy R, Sutton D, Guarro J. Purpureocillium lilacinum as a cause of cavitary pulmonary disease: a new clinical presentation and observations on atypical morphologic characteristics of the isolate. J Clin Microbiol. 2012;50:1800–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Al-Wathiqi F, Ahmad S, Khan ZU. Molecular characterization and antifungal susceptibility profile of Aspergillus flavus isolates recovered from clinical specimens in Kuwait. BMC Infect Dis. 2013;13:126. https://doi.org/10.1186/1471-2334-13-126.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Padhye AA, Ajello L, Wieden MA, Steinbronn KK. Phaeohyphomycosis of the nasal sinuses caused by a new species of Exserohilum. J Clin Microbiol. 1986;24:245–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Adam RD, Paquin ML, Petersen EA, et al. Phaeohyphomycosis caused by the fungal genera Bipolaris and Exserohilum. A report of 9 cases and review of the literature. Med (Baltim). 1986;65:203–7.

    Article  CAS  Google Scholar 

  10. Colton R, Zeharia A, Karmazyn B, Buller N, Levy Y, Inbal R, Zmira S, Yaniv E. Exserohilum sinusitis presenting as proptosis in a healthy adolescent male. J Adolesc Health. 2002;30:73–5.

    Article  PubMed  Google Scholar 

  11. Aviv JE, Lawson W, Bottone EJ, Sachdev VP, Som PM. Biller HF Multiple intracranial mucoceles associated with phaeohyphomycosis of the paranasal sinuses. Arch Otolaryngol Head Neck Surg. 1990;116:1210–3.

    Article  CAS  PubMed  Google Scholar 

  12. Friedman GC, Hartwick RW, Ro JY, Saleh GY, Tarrand JJ, Ayala AG. Allergic fungal sinusitis. Report of three cases associated with dematiaceous fungi. Am J Clin Pathol. 1991;96:368–72.

    Article  CAS  PubMed  Google Scholar 

  13. Manning SC, Schaefer SD, Close LG, Vuitch F. Culture-positive allergic fungal sinusitis. Arch Otolaryngol Head Neck Surg. 1991;117:174–8.

    Article  CAS  PubMed  Google Scholar 

  14. Torres C, Ro JY, el-Naggar AK, Sim SJ, Weber RS, Ayala AG. Allergic fungal sinusitis: a clinicopathologic study of 16 cases. Hum Pathol. 1996;27:793–9.

    Article  CAS  PubMed  Google Scholar 

  15. Cody DT 2nd, Neel HB 3rd, Ferreiro JA, Roberts GD. Allergic fungal sinusitis: the Mayo Clinic experience. Laryngoscope. 1994;104:1074–9.

    Article  PubMed  Google Scholar 

  16. Chakrabarti A, Kaur H. Allergic Aspergillus rhinosinusitis. J Fungi (Basel). 2016;2:2. https://doi.org/10.3390/jof2040032.

    Article  CAS  Google Scholar 

  17. Taj-Aldeen SJ, Hilal AA, Schell WA. Allergic fungal rhinosinusitis: a report of 8 cases. Am J Otolaryngol. 2004;25:213–8.

    Article  PubMed  Google Scholar 

  18. Al-Swiahb JN, Al-Ammar A, Al-Dousary SH. Allergic fungal sinusitis in Saudi Arabia. Saudi Med J. 2007;28:1711–4.

    PubMed  Google Scholar 

  19. Chatterjee SS, Chakrabarti A. Epidemiology and medical mycology of fungal rhinosinusitis. Otorhinolaryngol Clinics. 2009;1:1–13.

    Article  Google Scholar 

  20. Schubert MS. Allergic fungal sinusitis: pathophysiology, diagnosis and management. Med Mycol. 2009;47(Suppl. 1):S324–30.

    Article  CAS  PubMed  Google Scholar 

  21. McGinnis MR, Rinaldi MG, Winn RE. Emerging agents of phaeohyphomycosis: pathogenic species of Bipolaris and Exserohilum. J Clin Microbiol. 1986;24:250–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Gupta A, Xess I, Sharma SC, Mallick S. Invasive rhinosinusitis by Exserohilum rostratum in an immunocompetent child. BMJ Case Rep. 2014. https://doi.org/10.1136/bcr-2013-202380.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kohashi S, Toyama T, Hashimoto N, Sakurai M, Kato J, Kikuchi T, Koda Y, Sugita K, Hasegawa N, Yarita K, Kamei K, Okamoto S, Mori T. Sinusitis caused by Exserohilum rostratum after cord blood transplantation for myelodysplastic syndrome: a case report and literature review. Transpl Infect Dis. 2017. https://doi.org/10.1111/tid.12805.

    Article  PubMed  Google Scholar 

  24. Centers for Disease Control and Prevention (CDC). Multistate outbreak of fungal infection associated with injection of methylprednisolone acetate solution from a single compounding pharmacy–United States, 2012. MMWR Morb Mortal Wkly Rep. 2012;61:839–42.

    Google Scholar 

  25. Casadevall A. Pirofski L Exserohilum rostratum fungal meningitis associated with methylprednisolone injections. Future Microbiol. 2013;8:135–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Kontoyiannis DP, Perlin DS, Roilides E, Walsh TJ. What can we learn and what do we need to know amidst the iatrogenic outbreak of Exserohilum rostratum meningitis? Clin Infect Dis. 2013;57:853–9.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Gauthier GM, Keller NP. Crossover fungal pathogens: the biology and pathogenesis of fungi capable of crossing kingdoms to infect plants and humans. Fungal Genet Biol. 2013;61:146–57.

    Article  CAS  PubMed  Google Scholar 

  28. Litvintseva AP, Hurst S, Gade L, Frace MA, Hilsabeck R, Schupp JM, Gillece JD, Roe C, Smith D, Keim P, Lockhart SR, Changayil S, Weil MR, MacCannell DR, Brandt ME, Engelthaler DM. Whole-genome analysis of Exserohilum rostratum from an outbreak of fungal meningitis and other infections. J Clin Microbiol. 2014;52:3216–22.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Revankar SG, Moudgal V, Chandrasekar P, Sobel JD. In vitro studies of Exserohilum rostratum with antifungal drugs and methylprednisolone. Antimicrob Agents Chemother. 2014;58:3564–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Sharma K, Goss EM, Dickstein ER, Smith ME, Johnson JA, Southwick FS, Ariena HC, van Bruggen AHC. Exserohilum rostratum: characterization of a cross-Kingdom pathogen of plants and humans. PLoS ONE. 2014;9:e108691.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Plonk DP, Luong A. Current understanding of allergic fungal rhinosinusitis and treatment implications. Curr Opin Otolaryngol Head Neck Surg. 2014;22:221–6.

    Article  PubMed  Google Scholar 

  32. Farmakiotis D, Shirazi F, Zhao Y, Saad PJ, Albert ND, Roilides E, Walsh TJ, Perlin DS, Kontoyiannis DP. Methylprednisolone enhances the growth of Exserohilum rostratum in vitro, attenuates spontaneous apoptosis, and increases mortality rates in immunocompetent Drosophila flies. J Infect Dis. 2014;210(9):1471–5. https://doi.org/10.1093/infdis/jiu289.

    Article  CAS  PubMed  Google Scholar 

  33. Nicot J. The ecology of soil fungi: some characteristics of the Microflora in desert sands. Liverpool: Liverpool University Press; 1958. p. 94–7.

    Google Scholar 

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Acknowledgements

Technical support by Sandhya Vayalil and Omar Al-Musallam is thankfully acknowledged.

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Correspondence to Ziauddin Khan.

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The patient’s informed consent was obtained to publish this report.

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Handling Editor: Ferry Hagen.

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Alajmi, S., Koratum, R.M., Khan, Z. et al. Allergic Fungal Sinusitis Caused by Exserohilum rostratum and Literature Review. Mycopathologia 184, 89–96 (2019). https://doi.org/10.1007/s11046-018-0288-z

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  • DOI: https://doi.org/10.1007/s11046-018-0288-z

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