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. 1997 Feb;35(2):433–440. doi: 10.1128/jcm.35.2.433-440.1997

Invasive Nattrassia mangiferae infections: case report, literature review, and therapeutic and taxonomic appraisal.

L Sigler 1, R C Summerbell 1, L Poole 1, M Wieden 1, D A Sutton 1, M G Rinaldi 1, M Aguirre 1, G W Estes 1, J N Galgiani 1
PMCID: PMC229595  PMID: 9003611

Abstract

We report on a case of subcutaneous infection of the arm caused by the coelomycetous fungus Nattrassia mangiferae (formerly Hendersonula toruloidea) in a steroid-dependent diabetic man with chronic obstructive lung disease. The man was a resident of Arizona, where the fungus is known to be endemic on Eucalyptus camaldulensis and on citrus trees. Diagnosis of fungal infection was made by observation of narrow hyphal filaments by histopathology of biopsy specimens and isolation of a fast-growing black mold which demonstrated hyphae and arthroconidia of varying widths typical of the Scytalidium synanamorph (S. dimidiatum). The formation of pycnidia, which at maturity expressed conidia with a central median dark band, allowed for the confirmation of the isolate as N. mangiferae. Remission of the lesions occurred following intravenous therapy with amphotericin B, followed by topical clotrimazole treatment. We use this patient's case report as an opportunity to review the literature on cases of deep infection caused by Scytalidium species, to evaluate the antifungal susceptibilities of a spectrum of Scytalidium isolates, and to review the taxonomy of Scytalidium species isolated from human infections.

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Selected References

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  1. Benne C. A., Neeleman C., Bruin M., de Hoog G. S., Fleer A. Disseminating infection with Scytalidium dimidiatum in a granulocytopenic child. Eur J Clin Microbiol Infect Dis. 1993 Feb;12(2):118–121. doi: 10.1007/BF01967587. [DOI] [PubMed] [Google Scholar]
  2. Campbell C. K., Kurwa A., Abdel-Aziz A. H., Hodgson C. Fungal infection of skin and nails by Hendersonula toruloidea. Br J Dermatol. 1973 Jul;89(1):45–52. doi: 10.1111/j.1365-2133.1973.tb01916.x. [DOI] [PubMed] [Google Scholar]
  3. Campbell C. K., Mulder J. L. Skin and nail infection by Scytalidium hyalinum sp. nov. Sabouraudia. 1977 Jul;15(2):161–166. [PubMed] [Google Scholar]
  4. Campbell C. K. Studies on Hendersonula toruloidea isolated from human skin and nail. Sabouraudia. 1974 Jul;12(2):150–156. [PubMed] [Google Scholar]
  5. Costa A. R., Pires M. C., Porto E., Lacaz C. da S., Heins-Vaccari E. M., Maranhão W. M. Interdigital, cutaneous phaeohyphomycosis due to Scytalidium lignicola Pesante 1957. A case report. Mycoses. 1988 Dec;31(12):604–612. [PubMed] [Google Scholar]
  6. Costa E. F., Wanke B., Monteiro P. C., Porto E., Wanke N. C., Lacaz C. da S. Cutaneous phaeohyphomycosis caused by Scytalidium lignicola - report of the first three cases in Brazil. Mem Inst Oswaldo Cruz. 1989 Jan-Mar;84(1):135–136. doi: 10.1590/s0074-02761989000100024. [DOI] [PubMed] [Google Scholar]
  7. Dickinson G. M., Cleary T. J., Sanderson T., McGinnis M. R. First case of subcutaneous phaeohyphomycosis caused by Scytalidium lignicola in a human. J Clin Microbiol. 1983 Jan;17(1):155–158. doi: 10.1128/jcm.17.1.155-158.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Drouhet E., Dupont B. Laboratory and clinical assessment of ketoconazole in deep-seated mycoses. Am J Med. 1983 Jan 24;74(1B):30–47. doi: 10.1016/0002-9343(83)90512-0. [DOI] [PubMed] [Google Scholar]
  9. Espinel-Ingroff A., Dawson K., Pfaller M., Anaissie E., Breslin B., Dixon D., Fothergill A., Paetznick V., Peter J., Rinaldi M. Comparative and collaborative evaluation of standardization of antifungal susceptibility testing for filamentous fungi. Antimicrob Agents Chemother. 1995 Feb;39(2):314–319. doi: 10.1128/aac.39.2.314. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Frankel D. H., Rippon J. W. Hendersonula toruloidea infection in man. Index cases in the non-endemic North American host, and a review of the literature. Mycopathologia. 1989 Mar;105(3):175–186. doi: 10.1007/BF00437252. [DOI] [PubMed] [Google Scholar]
  11. Gallis H. A., Drew R. H., Pickard W. W. Amphotericin B: 30 years of clinical experience. Rev Infect Dis. 1990 Mar-Apr;12(2):308–329. doi: 10.1093/clinids/12.2.308. [DOI] [PubMed] [Google Scholar]
  12. Gentles J. C., Evans E. G. Infection of the feet and nails with Hendersonula toruloidea. Sabouraudia. 1970 May;8(1):72–75. [PubMed] [Google Scholar]
  13. Greer D. L., Gutierrez M. M. Tinea pedis caused by Hendersonula toruloidea. A new problem in dermatology. J Am Acad Dermatol. 1987 May;16(5 Pt 2):1111–1115. doi: 10.1016/s0190-9622(87)70144-3. [DOI] [PubMed] [Google Scholar]
  14. Gugnani H. C., Nzelibe F. K., Osunkwo I. C. Onychomycosis due to Hendersonula toruloidea in Nigeria. J Med Vet Mycol. 1986 Jun;24(3):239–241. [PubMed] [Google Scholar]
  15. Hay R. J., Clayton Y. M., Moore M. K., Midgely G. An evaluation of itraconazole in the management of onychomycosis. Br J Dermatol. 1988 Sep;119(3):359–366. doi: 10.1111/j.1365-2133.1988.tb03229.x. [DOI] [PubMed] [Google Scholar]
  16. Hay R. J. Ketoconazole in the treatment of fungal infection. Clinical and laboratory studies. Am J Med. 1983 Jan 24;74(1B):16–19. doi: 10.1016/0002-9343(83)90509-0. [DOI] [PubMed] [Google Scholar]
  17. Hay R. J., Mackie R. M., Clayton Y. M. Tioconazole nail solution--an open study of its efficacy in onychomycosis. Clin Exp Dermatol. 1985 Mar;10(2):111–115. doi: 10.1111/j.1365-2230.1985.tb00537.x. [DOI] [PubMed] [Google Scholar]
  18. Hay R. J., Moore M. K. Clinical features of superficial fungal infections caused by Hendersonula toruloidea and Scytalidium hyalinum. Br J Dermatol. 1984 Jun;110(6):677–683. doi: 10.1111/j.1365-2133.1984.tb04704.x. [DOI] [PubMed] [Google Scholar]
  19. Howell S. A., Moore M. K., Mallet A. I., Noble W. C. Sterols of fungi responsible for superficial skin and nail infection. J Gen Microbiol. 1990 Feb;136(2):241–247. doi: 10.1099/00221287-136-2-241. [DOI] [PubMed] [Google Scholar]
  20. Kane J., Porretta M., Krajden S., Goldhar J., Diena B. B. An autochthonous phaeohyphomycotic nail infection in Canada caused by Hendersonula toruloidea. Mycoses. 1990 Jan;33(1):37–40. doi: 10.1111/myc.1990.33.1.37. [DOI] [PubMed] [Google Scholar]
  21. Kombila M., Martz M., Gomez de Diaz M., de Bievre C., Richard-Lenoble D. Hendersonula toruloidea as an agent of mycotic foot infection in Gabon. J Med Vet Mycol. 1990;28(3):215–223. doi: 10.1080/02681219080000281. [DOI] [PubMed] [Google Scholar]
  22. Kotrajaras R., Chongsathien S., Rojanavanich V., Buddhavudhikrai P., Viriyayudhakorn S. Hendersonula toruloidea infection in Thailand. Int J Dermatol. 1988 Jul-Aug;27(6):391–395. doi: 10.1111/j.1365-4362.1988.tb02384.x. [DOI] [PubMed] [Google Scholar]
  23. Levi M. E., Smith J. W. Posttraumatic infection due to Scytalidium dimidiatum. Clin Infect Dis. 1994 Jan;18(1):127–128. doi: 10.1093/clinids/18.1.127. [DOI] [PubMed] [Google Scholar]
  24. Mariat F., Liautaud B., Liautaud M., Marill F. G. Hendersonula toruloidea, agent d'une dermatite verruqueuse mycosique observée en Algérie. Sabouraudia. 1978 Jun;16(2):133–140. [PubMed] [Google Scholar]
  25. Marill F. G., Liautaud M. M., Liautaud B., Mariat F. Dermatite verruqueuse mycosique due a un champignon dématié inhabituel. Discussion clinique et histopathologique. Bull Soc Pathol Exot Filiales. 1975 Jul-Aug;68(4):359–367. [PubMed] [Google Scholar]
  26. Moore M. K., Hay R. J. Circulating antibodies and antigenic cross-reactivity in Hendersonula toruloidea and Scytalidium hyalinum infections. Br J Dermatol. 1986 Oct;115(4):435–445. doi: 10.1111/j.1365-2133.1986.tb06238.x. [DOI] [PubMed] [Google Scholar]
  27. Moore M. K. Hendersonula toruloidea and Scytalidium hyalinum infections in London, England. J Med Vet Mycol. 1986 Jun;24(3):219–230. [PubMed] [Google Scholar]
  28. Moore M. K. Morphological and physiological studies of isolates of Hendersonula toruloidea Nattrass cultured from human skin and nail samples. J Med Vet Mycol. 1988 Feb;26(1):25–39. doi: 10.1080/02681218880000041. [DOI] [PubMed] [Google Scholar]
  29. Moore M. K. The infection of human skin and nail by Scytalidium species. Curr Top Med Mycol. 1992;4:1–42. doi: 10.1007/978-1-4612-2762-5_1. [DOI] [PubMed] [Google Scholar]
  30. Moore M. K., del Palacio-Hernanz A. D., Lopez-Gomez S. Scytalidium hyalinum infection diagnosed in Spain. Sabouraudia. 1984;22(3):243–245. [PubMed] [Google Scholar]
  31. Oyeka C. A., Gugnani H. C. In vitro activity of seven azole compounds against some clinical isolates of non-dermatophytic filamentous fungi and some dermatophytes. Mycopathologia. 1990 Jun;110(3):157–161. doi: 10.1007/BF00437540. [DOI] [PubMed] [Google Scholar]
  32. Pfaller M. A., Rinaldi M. G., Galgiani J. N., Bartlett M. S., Body B. A., Espinel-Ingroff A., Fromtling R. A., Hall G. S., Hughes C. E., Odds F. C. Collaborative investigation of variables in susceptibility testing of yeasts. Antimicrob Agents Chemother. 1990 Sep;34(9):1648–1654. doi: 10.1128/aac.34.9.1648. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Potekaev N. S., Minsker O. B., Biriukov A. V., Malkina A. Ia, Orlov S. L. Feogifomikoz kozhi, vyzvannyi Scytalidium lignicola (pervyi sluchai klinicheskogo nabliudeniia v SSSR). Ter Arkh. 1988;60(10):78–81. [PubMed] [Google Scholar]
  34. Rollman O., Johansson S. Hendersonula toruloidea infection: successful response of onychomycosis to nail avulsion and topical ciclopiroxolamine. Acta Derm Venereol. 1987;67(6):506–510. [PubMed] [Google Scholar]
  35. Sharkey P. K., Rinaldi M. G., Dunn J. F., Hardin T. C., Fetchick R. J., Graybill J. R. High-dose itraconazole in the treatment of severe mycoses. Antimicrob Agents Chemother. 1991 Apr;35(4):707–713. doi: 10.1128/aac.35.4.707. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Summerbell R. C., Kane J., Krajden S. Onychomycosis, tinea pedis and tinea manuum caused by non-dermatophytic filamentous fungi. Mycoses. 1989 Dec;32(12):609–619. doi: 10.1111/j.1439-0507.1989.tb02192.x. [DOI] [PubMed] [Google Scholar]
  37. Zaatari G. S., Reed R., Morewessel R. Subcutaneous hyphomycosis caused by Scytalidium hyalinum. Am J Clin Pathol. 1984 Aug;82(2):252–256. doi: 10.1093/ajcp/82.2.252. [DOI] [PubMed] [Google Scholar]
  38. al-Rajhi A. A., Awad A. H., al-Hedaithy S. S., Forster R. K., Caldwell K. C. Scytalidium dimidiatum fungal endophthalmitis. Br J Ophthalmol. 1993 Jun;77(6):388–390. doi: 10.1136/bjo.77.6.388. [DOI] [PMC free article] [PubMed] [Google Scholar]

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