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Biomedical subjects

L Ajello

Publications and source records attributed to L Ajello.

At least 127 records · Page 7Linked to original sources

Pulmonary histoplasmosis associated with exploration of a bat cave.

Approximately 14 days after exploring a limestone cave in northcentral Florida in February 1973, an 18-year-old female developed a respiratory illness with pronounced shortness of breath and cyanosis. The following day, an 18-year-old male presented to the hospital with similar complaints. The association of illness with their recent caving experience prompted further epidemiologic investigation. Twenty-nine members of a church-sponsored youth group explored the implicated cave. Twenty-three of them later became ill with complaints of cough, afternoon fever and sweats, chest discomfort, and dyspnea on exertion. Histoplasmin skin tests were positive in 18 of 24 individuals tested. Serum for complement fixation (CF) was positive in 12 of 26. Testing of area residents revealed a low incidence of skin test and CF positivity (7% and 0%, respectively). That spelunkers are at risk of acquiring pulmonary histoplasmosis has been noted previously; in Florida this has been related to the exploration of caves infested with bats. This is the largest reported outbreak of acute pulmonary histoplasmosis that has been associated with spelunking and further points out that only those individuals who enter the cave are at risk of acquiring the disease, and not those who reside in the surrounding area.

Adolescent↗

Acremonium recifei as an agent of mycetoma in India.

Acremonium recifei was identified as the causal agent in a case of white grain eumycotic mycetoma of the hand which occurred in South India. The identification was based on the structure of the granules in tissue and on the morphological characteristics of the culture obtained from the granules. This case represents the first documented instance in which A. recifei has been found outside of Latin America.

Adult↗

Thermotolerance of Wangiella dermatitidis.

A variety of diagnostic tests used by many laboratories to identify isolates of Wangiella dermatitidis (= Fonsecaea dermatitidis) were evaluated. Thirteeen isolates of W. dermatitidis were studied with respect to their ability to grow at 25, 37, 40, 45, and 50 degrees C, colonial and micromorphology, gelatin liquefaction, and hydrolysis of casein, xanthine, hypoxanthine, and tyrosine. All 13 isolates showed growth at 25, 37, and 40 degrees C but failed to grow at higher temperatures. The ability of W. dermatitidis to grow at 40 degrees C can be useful in its identification.

Diagnosis, Differential↗

Occurrence of Blastomyces dermatitidis in Israel. First autochthonous Middle Eastern case.

A nodule from the infrapatellar region of the left knee of a patient in Israel was found by fluorescent antibody staining to contain the tissue form cells of Blastomyces dermatitidis. The diagnosis was confirmed by culture and other mycological studies when a second lesion appeared below the right knee. This represents the first autochthonous case of blastomycosis from Israel and the Middle East.

Aged↗

An epidemic of histoplasmosis on the Isthmus of Panama.

Forty-seven men on the Isthmus of Panama were exposed to histoplasmosis in an old bunker inhabited by bats. The resulting epidemic was studied with serial clinical, serological, and radiological examinations. Thirty-seven (78.7%) of the men showed serological evidence of infection and 26 (70.3%) had symptoms. Incubation periods ranged from 4 to 30 days. A general relationship between severity of illness and degree of exposure was noted. The agar gel diffusion test for precipitin antibodies was more sensitive than the complement-fixation test or slide test in detecting infection with Histoplasma capsulatum. Decontamination procedures and environmental studies are described.

Amphotericin B↗

Histoplasmosis in Belize, Central America.

After two small outbreaks of histoplasmosis in Belize, an epidemiologic survey was carried out. Forty percent of 141 persons in two groups tested demonstrated a positive histoplasmin reaction. In one study group there was a significant association between visiting caves and histoplasmin positivity. Histoplasma capsulatum was not isolated in 20 soil specimens collected from outbreak-associated caves, but was isolated from 1 of 26 bats collected from the same caves. The presence of histoplasmosis in Belize, C.A. is documented, and this disease should be considered in differential diagnosis in patients, both residents and visitors in Belize, with compatible clinical presentations.

Adolescent↗

Zygomycosis of the maxillary sinus and palate caused by Basidiobolus haptosporus.

Basidiobolus haptosporus is known to cause subcutaneous zygomycosis in tropical Africa and Asia. We cared for a 49-year-old hyperglycemic, asplenic man who had never traveled outside the United States and who was seen initially for a painless palatal ulcer with cutaneous hypesthesia of the right cheek and upper lip. An invasive process involved the right middle nasal turbinate, maxillary antrum, maxillary division of the trigeminal nerve, and bony palate. Histological examination of biopsy tissue showed necrotizing granulomata with broad, nonseptate hyphae. Basidiobolus haptosporus was cultured from this tissue. Various laboratory studies revealed no immunologic defect and his lesions responded to therapy with amphotericin B. To our knowledge, this represents the first case of zygomycosis caused by B haptosporus in the Americas and the first culture-documented case of invasive mycosis caused by this mold.

Fungi↗

[Current knowledge on imperfect and perfect forms of Epidermophyton, Microsporum and Trichophyton species].

The taxonomic status of the members of the form genera: Epidermophyton, Microsporum and Trichophyton is critically appraised. Two species of epidermophyton, 16 of Microsporum and 21 of Trichophyton are considered to be valid. Currently the perfect status of nine Microsporum and eight Trichophyton species have been described. They are respectively classified in the genera Nannizzia and Arthroderma. The value of the tester strains of the heterothallic perfect states in resolving taxonomic problems is discussed.

Epidermophyton↗

An outbreak of histoplasmosis at an Arkansas courthouse with five cases of probable reinfection.

An outbreak of histoplasmosis occurred at a county courthouse in Arkansas in July, 1975. Fifty cases were identified by symptoms and positive complement fixation (CF) tests and 18 others by the clinical findings alone. Only three positive CF tests (greater than or equal to 1:8) were found in a control group of 55 unexposed persons of the same age. The attack rate for 84 courthouse employees was 52%. Histoplasma capsulatum was isolated from the sputum of two cases, and from bird droppings which had been dumped from the roof of the courthouse two weeks before the epidemic's peak. Window air conditioners apparently helped to distribute infectious particles throughout the building. Nine exposed people had pulmonary calcifications and a negative tuberculin test that were taken as presumptive evidence of previous histoplasmosis. Five (55%) of these became ill. Exposed persons without pulmonary calcifications had an attack rate of 85%. The reinfected cases during convalescence had higher serum CF titers but not larger histoplasmin skin test diameters than the rest of the cases. A microdroplet aerosol of cooking oil was used to simulate air flow patterns during the exposure, and the results agreed with the hypothesized means of infection.

Adult↗

An outbreak of phaeohyphomycosis in rainbow trout caused by Scolecobasidium humicola.

A previously undescribed host for the opportunistic dematiaceous hyphomycete, Scolecobasidium humicola, is reported. Several epizootics among rainbow trout, Salmo gairdneri, occurred in a Tennessee fish hatchery from 1969 to 1973. Symptoms included surface lesions, blisters and abscesses. The kidneys and other internal organs were invaded by the mycelium of S. humicola. Tissue morphology of the fungus was typical of that associated with phaeohyphomycosis Experimental infections were reproduced in fingerling rainbow trout after intraperitoneal inoculation of S. humicola. Following a change in the hatchery's water supply, no new epizootics have occurred.

Animals↗

Cranial zygomycosis caused by Saksenaea vasiformis. Case report.

A previously healthy youth who had sustained severe head trauma and had received steroids and broad-spectrum antimicrobial agents developed a cranial zygomycotic infection with Saksenaea vasiformis. This is the first time this zygomycete has been implicated as a disease agent. Early identification of the fungal infection and subsequent vigorous medical and surgical therapy led to recovery.

Adult↗

Occurrence of Histoplasma capsulatum Darling, 1906 in Israel, with a review of the current status of histoplasmosis in the Middle East.

The isolation of Histoplasma capsulatum from a bat cave in the Galilee region of Israel is reported along with the discovery of a bat (Myotis myotis) infected by H. capsulatum. Soils collected in avian and chiropteran habitats throughout Israel also yielded the following fungi of medical interest: Arthroderma quadrifidum, A. tuberculatum, Candida parapsilosis, Chrysosporium indicum, C. keratinophilum, C. tropicum, Cryptococcus neoformans, Ctenomyces serratus, Microsporum gypseum, and Petriellidium boydii. All available reports concerning the occurrence of H. capsulatum and histoplasmosis in the Middle East are critically reviewed.

Animals↗

First European report of swine infection by Microsporum nanum.

The first European case of swine infection by Microsporum nanum is reported. The infected pig came from a farm in the Emilia-Romagna region of Italy. European records of human and lower animal infections by this fungus and soil isolation records are discussed.

Animals↗

Susceptibility of Prototheca species to antifungal agents.

Twenty isolates of Prototheca filamenta, Prototheca moriformis, Prototheca stagnora, Prototheca wickerhamii, and Prototheca zopfii were tested for in vitro susceptibility to five commonly used antifungal agents: amphotericin B, 5-fluorocytosine, griseofulvin, miconazole, and nystatin. The results revealed resistance to griseofulvin of all the Prototheca isolates tested and an inhibitory effect on P. filamenta by high 5-fluorocytosine concentrations (minimal inhibitory concentration [MIC] = 12.5 to 100 mug/ml; minimal fungicidal or algacidal concentration [MFC/MAC] = 50 to 100 mug/ml). P. filamenta isolates were also susceptible to miconazole (MIC = 0.1 to 0.5 mug/ml, MFC/MAC = 0.5 to 1 mug/ml); isolates of the other Prototheca species varied in regard to miconazole activity from susceptible to resistant (MIC = 1 - >100 mug/ml, MFC/MAC = 5 - >100 mug/ml). The Prototheca isolates revealed an in vitro susceptibility to the polyene antifungal agents, amphotericin B, and nystatin (MIC = 0.09 to 3.12 mug/ml and 0.19 to 12.5 mug/ml, respectively; MFC/MAC = 0.19 to 25 mug/ml and 0.75 to 25 mug/ml, respectively).

Amphotericin B↗

Evaluation of a new system for the rapid identification of clinically important yeasts.

The rapid system developed by Huppert et al. (1975) for the identification of yeasts based on assimilation and fermentation patterns and on germ tube and pseudohyphal production was evaluated in a comparative study with conventional procedures. The 95 test cultures were members of the genera Candida, Cryptococcus, Rhodotorula, Saccharomyces, Torulopsis, and Trichosporon. The study revealed that approximately 94% of the isolates were correctly identified by the rapid method in comparison with the standard method. With the rapid method identification was accomplished in 72h, and with the conventional procedures identification was completed in 2 weeks. Although it was difficult with some isolates to obtain definitive speciation by the rapid method, this method promises to be especially useful in clinical laboratories for the identification of yeasts of medical importance. Modifications were made in the procedure of Huppert et al. (1975) to improve the reading of reactions. Commercial media and a disk dispenser to make the method more useful were also investigated.

Carbohydrate Metabolism↗

Fatal aspergillosis in imported parrots.

Spontaneous fatal aspergillosis occurred in several species of parrots imported from Latin America, Australia, Malaya and Ghana for studies on the control of psittacosis. Over a period of 4 years, 655 parrots were imported for use in these studies. All birds that died during these investigations were necropsied, and the internal organs of 45 were found to have macroscopic lesions suggestive of aspergillosis. Of these 45 suspected cases, 32 were confirmed as aspergillosis by both histopathology and culture, and three others by histopathology alone. There was no evidence that the remaining 10 had this disease. Of the 32 culturally confirmed cases, 13 were found to be caused by Aspergillus fumigatus, 16 by A. oryzae, and three by both fungi. In this series, three sets of circumstances appear to have been associated with the development of fatal aspergillosis. Their capture and transport to the United States, the administration of chlortetracycline used in the control of psittacosis, and the administration of cortisone acetate in an attempt to activate existent latent psittacosis infections. The possible causal relationship of these factors are discussed.

Animals↗