Subcutaneous phaeohyphomycotic nodule due to Phialemoniopsis hongkongensis sp. nov

J Clin Microbiol. 2014 Sep;52(9):3280-9. doi: 10.1128/JCM.01592-14. Epub 2014 Jun 25.

Abstract

Phialemoniopsis species are ubiquitous dematiaceous molds associated with a wide variety of superficial and systemic infections in human. In this study, we isolated a mold from the forearm nodule biopsy specimen from a patient with underlying liver cirrhosis, ankylosing spondylosis, and tuberculosis. He was treated with itraconazole, but unfortunately, he succumbed as a result of disseminated tuberculosis with multiorgan failure. The histology results of the skin biopsy showed necrotizing granulomas in which numerous fungal elements were found. On Sabouraud dextrose agar, the fungal isolate grew as white-to-cream and smooth-to-velvety colonies. Microscopically, oval-to-cylindrical conidia were observed from abundant adelophialides, which possessed barely visible parallel collarettes but no basal septa. The azole drugs voriconazole, itraconazole, and posaconazole, as well as amphotericin B, showed high activities against this fungus. Internal transcribed spacer, 28S nuclear ribosomal DNA (nrDNA), and β-actin and β-tubulin gene sequencing showed that this fungus is most closely related to but distinct from Phialemonium curvata. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and hierarchical cluster analysis showed that the MALDI-TOF MS spectrum of this fungus is most closely related to that of Phialemonium pluriloculosa. We propose a new species, Phialemoniopsis hongkongensis sp. nov., to describe this fungus.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actins / genetics
  • Antifungal Agents / pharmacology
  • Biopsy
  • Cluster Analysis
  • Coinfection / diagnosis
  • Coinfection / microbiology
  • DNA, Fungal / chemistry
  • DNA, Fungal / genetics
  • DNA, Ribosomal / chemistry
  • DNA, Ribosomal / genetics
  • DNA, Ribosomal Spacer / chemistry
  • DNA, Ribosomal Spacer / genetics
  • Fatal Outcome
  • Histocytochemistry
  • Humans
  • Liver Cirrhosis / complications
  • Male
  • Microbiological Techniques
  • Middle Aged
  • Molecular Sequence Data
  • Phaeohyphomycosis / diagnosis*
  • Phaeohyphomycosis / microbiology*
  • Phylogeny
  • RNA, Ribosomal, 28S / genetics
  • Sequence Analysis, DNA
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
  • Spondylitis, Ankylosing / complications
  • Tuberculosis / complications
  • Tubulin / genetics
  • Xylariales / classification*
  • Xylariales / drug effects
  • Xylariales / genetics
  • Xylariales / isolation & purification*

Substances

  • Actins
  • Antifungal Agents
  • DNA, Fungal
  • DNA, Ribosomal
  • DNA, Ribosomal Spacer
  • RNA, Ribosomal, 28S
  • Tubulin

Associated data

  • GENBANK/KJ573442
  • GENBANK/KJ573461