Fungal Infections of Implantation: More Than Five Years of Cases of Subcutaneous Fungal Infections Seen at the UK Mycology Reference Laboratory
Subcutaneous fungal infections, which typically result from traumatic introduction (implantation) of fungal elements into the skin or underlying tissues, can present as a range of different clinical entities including phaeohyphomycosis, chromoblastomycosis, subcutaneous nodules or masses, and genuin...
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| Format: | Article |
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MDPI AG
2022-03-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/8/4/343 |
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| author | Andrew M. Borman Mark Fraser Zoe Patterson Christopher J. Linton Michael Palmer Elizabeth M. Johnson |
| author_facet | Andrew M. Borman Mark Fraser Zoe Patterson Christopher J. Linton Michael Palmer Elizabeth M. Johnson |
| author_sort | Andrew M. Borman |
| collection | DOAJ |
| description | Subcutaneous fungal infections, which typically result from traumatic introduction (implantation) of fungal elements into the skin or underlying tissues, can present as a range of different clinical entities including phaeohyphomycosis, chromoblastomycosis, subcutaneous nodules or masses, and genuine eumycetoma. Here, we mined our laboratory information management system for such infections in humans and domestic animals for the period 2016–2022, including (i) fungal isolates referred for identification and/or susceptibility testing; (ii) infections diagnosed at our laboratory using panfungal PCR approaches on infected tissue; and (iii) organisms cultured in our laboratory from biopsies. In total, 106 cases were retrieved, involving 39 fungal species comprising 26 distinct genera. Subcutaneous infections with <i>Alternaria</i> species were the most frequent (36 cases), which possibly reflects the ubiquitous nature of this common plant pathogen. A substantial proportion of <i>Alternaria</i> spp. isolates exhibited reduced in vitro susceptibility to voriconazole. Notably, a significant number of subcutaneous infections were diagnosed in renal and other solid organ transplant recipients post transplantation, suggesting that humans may harbour “inert” subcutaneous fungal elements from historical minor injuries that present as clinical infections upon later immunosuppression. The current study underscores the diversity of fungi that can cause subcutaneous infections. While most organisms catalogued here were responsible for occasional infections, several genera (<i>Alternaria, Exophiala, Phaeoacremonuim, Scedosporium</i>) were more frequently recovered in our searches, suggesting that they possess virulence factors that facilitate subcutaneous infections and/or inhabit natural niches that make them more likely to be traumatically inoculated. |
| first_indexed | 2024-03-09T04:31:40Z |
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| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-09T04:31:40Z |
| publishDate | 2022-03-01 |
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| series | Journal of Fungi |
| spelling | doaj.art-45027951f46c4ae695167bafda91c5872023-12-03T13:34:25ZengMDPI AGJournal of Fungi2309-608X2022-03-018434310.3390/jof8040343Fungal Infections of Implantation: More Than Five Years of Cases of Subcutaneous Fungal Infections Seen at the UK Mycology Reference LaboratoryAndrew M. Borman0Mark Fraser1Zoe Patterson2Christopher J. Linton3Michael Palmer4Elizabeth M. Johnson5UK Health Security Agency National Mycology Reference Laboratory, Southmead Hospital, Bristol BS10 5NB, UKUK Health Security Agency National Mycology Reference Laboratory, Southmead Hospital, Bristol BS10 5NB, UKUK Health Security Agency National Mycology Reference Laboratory, Southmead Hospital, Bristol BS10 5NB, UKUK Health Security Agency National Mycology Reference Laboratory, Southmead Hospital, Bristol BS10 5NB, UKUK Health Security Agency National Mycology Reference Laboratory, Southmead Hospital, Bristol BS10 5NB, UKUK Health Security Agency National Mycology Reference Laboratory, Southmead Hospital, Bristol BS10 5NB, UKSubcutaneous fungal infections, which typically result from traumatic introduction (implantation) of fungal elements into the skin or underlying tissues, can present as a range of different clinical entities including phaeohyphomycosis, chromoblastomycosis, subcutaneous nodules or masses, and genuine eumycetoma. Here, we mined our laboratory information management system for such infections in humans and domestic animals for the period 2016–2022, including (i) fungal isolates referred for identification and/or susceptibility testing; (ii) infections diagnosed at our laboratory using panfungal PCR approaches on infected tissue; and (iii) organisms cultured in our laboratory from biopsies. In total, 106 cases were retrieved, involving 39 fungal species comprising 26 distinct genera. Subcutaneous infections with <i>Alternaria</i> species were the most frequent (36 cases), which possibly reflects the ubiquitous nature of this common plant pathogen. A substantial proportion of <i>Alternaria</i> spp. isolates exhibited reduced in vitro susceptibility to voriconazole. Notably, a significant number of subcutaneous infections were diagnosed in renal and other solid organ transplant recipients post transplantation, suggesting that humans may harbour “inert” subcutaneous fungal elements from historical minor injuries that present as clinical infections upon later immunosuppression. The current study underscores the diversity of fungi that can cause subcutaneous infections. While most organisms catalogued here were responsible for occasional infections, several genera (<i>Alternaria, Exophiala, Phaeoacremonuim, Scedosporium</i>) were more frequently recovered in our searches, suggesting that they possess virulence factors that facilitate subcutaneous infections and/or inhabit natural niches that make them more likely to be traumatically inoculated.https://www.mdpi.com/2309-608X/8/4/343subcutaneous fungal infectionsantifungal susceptibility<i>Alternaria</i>eumycetomaphaeohyphomycosissolid organ transplant |
| spellingShingle | Andrew M. Borman Mark Fraser Zoe Patterson Christopher J. Linton Michael Palmer Elizabeth M. Johnson Fungal Infections of Implantation: More Than Five Years of Cases of Subcutaneous Fungal Infections Seen at the UK Mycology Reference Laboratory Journal of Fungi subcutaneous fungal infections antifungal susceptibility <i>Alternaria</i> eumycetoma phaeohyphomycosis solid organ transplant |
| title | Fungal Infections of Implantation: More Than Five Years of Cases of Subcutaneous Fungal Infections Seen at the UK Mycology Reference Laboratory |
| title_full | Fungal Infections of Implantation: More Than Five Years of Cases of Subcutaneous Fungal Infections Seen at the UK Mycology Reference Laboratory |
| title_fullStr | Fungal Infections of Implantation: More Than Five Years of Cases of Subcutaneous Fungal Infections Seen at the UK Mycology Reference Laboratory |
| title_full_unstemmed | Fungal Infections of Implantation: More Than Five Years of Cases of Subcutaneous Fungal Infections Seen at the UK Mycology Reference Laboratory |
| title_short | Fungal Infections of Implantation: More Than Five Years of Cases of Subcutaneous Fungal Infections Seen at the UK Mycology Reference Laboratory |
| title_sort | fungal infections of implantation more than five years of cases of subcutaneous fungal infections seen at the uk mycology reference laboratory |
| topic | subcutaneous fungal infections antifungal susceptibility <i>Alternaria</i> eumycetoma phaeohyphomycosis solid organ transplant |
| url | https://www.mdpi.com/2309-608X/8/4/343 |
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