Vascular pythiosis caused by Pythium aphanidermatum: the first case report in Asia

Pythium, soil-borne plant pathogens, are in the class Oomycetes. They are not true fungi, but are related to diatom and algae. There are two human pathogens including P. insidiosum and P. aphanidermatum. To date, only one case of pythiosis caused by P. aphanidermatum has been reported. We present he...

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Bibliographic Details
Published in:European journal of medical research 2021-11, Vol.26 (1), p.132-3, Article 132
Main Authors: Thongsuk, Pannaporn, Plongla, Rongpong, Thammahong, Arsa, Tiewsurin, Jaruwan, Worasilchai, Navaporn, Chindamporn, Ariya, Suankratay, Chusana
Format: Article
Language:English
Subjects:
Antifungal Agents - therapeutic use
Asia
Azithromycin - therapeutic use
Blood diseases
Case Report
Coronary vessels
Enzymes
Fatal Outcome
Female
Fungi
Hospitals
Host-Pathogen Interactions - drug effects
Humans
Hyphae - drug effects
Hyphae - physiology
Infections
Itraconazole
Itraconazole - therapeutic use
Middle Aged
Morphology
Pathogens
Pythiosis
Pythiosis - diagnosis
Pythiosis - drug therapy
Pythiosis - microbiology
Pythium
Pythium - drug effects
Pythium - physiology
Pythium aphanidermatum
Pythium insidiosum
Ribosomal DNA
Surgery
Terbinafine - therapeutic use
Thailand
Thrombosis - microbiology
Trauma
Veins & arteries
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Summary:Pythium, soil-borne plant pathogens, are in the class Oomycetes. They are not true fungi, but are related to diatom and algae. There are two human pathogens including P. insidiosum and P. aphanidermatum. To date, only one case of pythiosis caused by P. aphanidermatum has been reported. We present herein the first case of P. aphanidermatum vascular pythiosis in Asia. A 47-year-old Thai woman, living in North Thailand, with ß thalassemia/hemoglobin E presented with acute recurrent arterial insufficiency of both legs. Emergent embolectomy with clot removal was performed. The pathology of the clot exhibited noncaseous granulomatous inflammation with many fungal hyphal elements. PCR identified P. aphanidermatum with 100% identity. Final diagnosis is vascular pythiosis. Unfortunately, the patient eventually expired after treatment with itraconazole, terbinafine, azithromycin, and doxycycline. To date, only one case of pythiosis caused by P. aphanidermatum has been reported. We present herein the first case of P. aphanidermatum vascular pythiosis in Asia.
ISSN:2047-783X
0949-2321
2047-783X
DOI:10.1186/s40001-021-00603-w