Abstract Primary cutaneous aspergillosis is a rare disease usually caused by Aspergillus fumigatus, Aspergillus flavus, Aspergillus terreus and Aspergillus ustus. It is usually seen in immunocompromised hosts, though some cases are also reported in immunocompetent hosts. We present a case of an immunocompetent farmer who presented with generalised nodules and plaques, mimicking erythema nodosum leprosum but turned out to be cutaneous aspergillosis caused by Aspergillus tamarii. The characteristic ascospores of Aspergillus species were found in skin lesions on fungus isolated in culture.
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Address correspondence to Patrick C. Woo, kh. Lau, kh. All Rights Reserved. This article has been cited by other articles in PMC. Abstract Aspergillus nomius and Aspergillus tamarii are Aspergillus species that phenotypically resemble Aspergillus flavus. In the last decade, a number of case reports have identified A.
The other three isolates were A. The results corresponded with those of metabolic fingerprinting, in which the A. The first two patients with A. Identification of the 11 clinical isolates and three reference strains by matrix-assisted laser desorption ionization—time of flight mass spectrometry MALDI-TOF MS showed that only six of the nine strains of A.
None of the strains of A. In immunocompetent hosts, Aspergillus species rarely cause serious illnesses, except for aspergilloma in patients with preexisting chronic lung diseases and a few related chronic pulmonary diseases related to Aspergillus, including chronic cavitary pulmonary aspergillosis, chronic fibrosing aspergillosis, and chronic necrotizing aspergillosis 6.
In contrast, invasive aspergillosis is one of the most important causes of morbidity and mortality in immunocompromised patients, such as those with hematological malignancies who undergo chemotherapy, marrow and solid organ transplant recipients, and HIV-positive patients 1 , 7.
Among the known Aspergillus species, Aspergillus fumigatus is the most common one causing infections in humans in Western countries, whereas Aspergillus flavus is as important as A. The other Aspergillus species commonly associated with human infections include Aspergillus niger and Aspergillus terreus 1 , 7. Traditionally, identification of Aspergillus species in clinical microbiology laboratories has relied on isolating the fungus and microscopically examining them for characteristic features.
In the last decade, more widespread use of internal transcribed spacer 1 ITS1 In addition, it has led to the discovery of novel pathogenic fungal species 11 , Since A. Eleven fungal isolates reported as A.
The hospital records of the three patients with A. Three reference strains, including A. Phenotypic characterization.
Slides for microscopic examination were prepared using the agar block smear method we described recently Fungal cells on SDA were harvested with a sterilized cotton swab and suspended in 1 ml of autoclaved distilled water.
Ten microliters of each amplified product was electrophoresed in 1. Phylogenetic characterization. Poorly aligned or divergent regions of the aligned DNA sequences were removed using Gblocks 0. The test for substitution model and phylogenetic tree construction, by the maximum likelihood method, were performed using MEGA 5. Metabolic fingerprinting was performed according to our previous publication, with modifications The culture supernatant was filtered using a 0. The injection volume was 5.
The separation was performed at a flow rate of 0. The capillary voltage was set at 3, V with a nozzle voltage of 0 V. Two biological replicate experiments were performed for each sample. The mixture was vortexed and centrifuged at 14, rpm for 5 min. The supernatant was removed, and the pellet was air dried for 2 h.
An equal volume of acetonitrile Fluka, USA was added, followed by centrifugation at 14, rpm for 5 min. A representative spectrum of each strain was selected for hierarchical cluster analysis with LaunchPad software version 2.
Nucleotide sequence accession numbers. Among the 11 patients, seven were male and four were female. Their median age was 69 years range, 52 to 87 years. Phenotypic characteristics. The 11 clinical isolates and the reference strains were grown on SDA for morphology-based identification. Among these 11 clinical isolates, 10 produced velvety colonies with floccose tufts and yellowish green conidia Fig.
The reverse of the colonies was dull yellow or orange-brown. The conidiophores were hyaline, with globose to subglobose vesicles and biseriate phialides Fig.
The conidia were globose to subglobose. However, one of the clinical isolates, PW, produced dark green-brown conidia at maturity and formed velutinous colonies with floccose tufts and showed phenotypic morphology that was the same as that of the reference strain A.
The reverse of the colony was dull yellow. The conidiophores of PW were hyaline with globose vesicles and biseriate phialides producing brownish-yellow conidia Fig.
J Clin Microbiol. Published online Aug Phone: 91 Fax: 91 E-mail: gro. Abstract We report a case of Aspergillus tamarii keratitis.