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Volume 26, Number 9—September 2020

Invasive Infections with Nannizziopsis obscura Species Complex in 9 Patients from West Africa, France, 2004–20201

Dea Garcia-HermosoComments to Author , Samia Hamane, Arnaud Fekkar, Arnaud Jabet, Blandine Denis, Martin Siguier, Guy Galeazzi, Elie Haddad, Sophie Brun, Valérie Vidal, Gilles Nevez, Rozenn Le Berre, Maud Gits-Muselli, Fanny Lanternier, and Stéphane Bretagne
Author affiliations: Institut Pasteur, Paris, France (D. Garcia-Hermoso, F. Lanternier, S. Bretagne); Hôpitaux Lariboisière–Saint-Louis-Fernand Widal, Assistance Publique–Hôpitaux de Paris, Paris (S. Hamane, A. Jabet, B. Denis, M. Siguier, M. Gits-Muselli, S. Bretagne); Groupe Hospitalier Pitié–Salpêtrière, Assistance Publique–Hôpitaux de Paris, Sorbonne Université, Paris (A. Fekkar); Hôpital Max Fourestier, Nanterre, France (G. Galeazzi); Centre Hospitalier Universitaire Hôtel-Dieu de France, Université de Saint-Joseph, Beirut, Lebanon (E. Haddad); Hôpital Avicenne, Assistance Publique–Hôpitaux de Paris, Bobigny, France (S. Brun, V. Vidal); Hôpital La Cavale Blanche, Centre Hospitalier Universitaire de Brest, Brest, France (G. Nevez, R. Le Berre); Université Paris 13, Paris (S. Brun); Université de Paris, Paris (M. Gits-Muselli, F. Lanternier, S. Bretagne)

Main Article

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).

Main Article

1Preliminary results of this study were presented at the International Society for Human and Animal Mycology, June 30–July 4, 2018, Amsterdam, the Netherlands (poster 174, Medical Mycology 56, Supplement 2).

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