Table 1. Clinical and laboratory characteristics of invasive infections with Nannizziopsis obscura in 9 patients from West Africa, France 2004–2020*.
| Patient no./ CNRMA strain no. | Year of diagnosis | Patient age, y/sex | Underlying risk factors | Country of birth/time since last travel in Africa | Clinical, radiologic, and biological findings | Direct examination | Serum β-D-glucan (Fungitell), pg/mL | Suspected identification at diagnosis | Treatment (duration) | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|
| P1/4.1162 | 2004 | 49/M | AIDS | Mali/2 mo | Liver abscess† | Hyphae and arthroconidia | Not done | Trichosporon sp., Chrysosporium sp. | LAMB (unknown) | Lost to follow-up |
| P2/9.1232 | 2009 | 50/M | Heart transplant 2 mo earlier | Mali/NA | Fungemia,† cutaneous ulcers | Not done | Not done | Chrysosporium sp. | None | Death 2 d after diagnosis |
| P3/17.78 | 2016 | 58/F | Diabetes, Renal transplant (2017) | Mali/NA | Disseminated subcutaneous abscess† (legs, back) and pulmonary nodules | Septate, vesiculous mycelia, clavate sessile conidia | >500 | Trichophyton rubrum | Posaconazole | No relapse after 1 y |
| P4/17.507 | 2017 | 62/M | Renal transplant (2009) | Guinea/1 y | Suppurated lesions (right ankle)† and lung micronodules, β-D-glucan+ | Hyphae and arthroconidia | >500 | Trichosporon sp. | Posaconazole | No relapse after 2 y |
| P5/18.682 | 2018 | 69/F | Mantle cell lymphoma (2017) | Guinea-Bissau/2 y | Pulmonary nodules, bronchial ulcerations and hyperchromic skin nodules,† β-D-glucan+ | Hyphae and arthroconidia | >500 | Trichophyton rubrum | Terbinafine, then voriconazole and LAMB | Death 6 wks after skin biopsy |
| P6/18.740 | 2018 | 28/F | Not known | Guinea/2 y | Mediastin (deep abscess)† | Hyphae | 306 | Trichophyton rubrum | Posaconazole, then voriconazole | Lost to follow-up |
| P7/19.38 | 2018 | 38/M | Renal transplant (2015) | Mali/1 y | Brain abscess† | Septate hyphae | >500 | Candida sp. | LAMB and fluconazole, then LAMB and voriconazole | Alive 12 mo later |
| P8/19.607 | 2019 | 79/M | Renal transplant (2014) | Mali/3 y | Subcutaneous abscess (hand)† and pulmonary nodules, β-D-glucan+ | Septate, vesiculous mycelia, clavate sessile conidia | 255 | Trichophyton rubrum | Itraconazole ongoing | Alive 4 mo later |
| P9/20.123 | 2019 | 65/M | Renal transplant (2018) | Mali/6 mo | Subcutaneous abscess (clavicle) and fistula with pus | Hyphae | >520 | Nannizziopsis sp. | Voriconazole (ongoing) | Alive |
*CNRMA, Centre National de Référence Mycoses Invasives et Antifongiques; LAMB, liposomal amphotericin B. †Original site of isolation (in cases when multiple sites were sampled).