Phialemonium: An Emerging Mold Pathogen That Caused 4 Cases of Hemodialysis-Associated Endovascular Infection

Phialemonium species are emerging as fungal opportunistic pathogens of humans; infections caused by these fungi often have a fatal outcome. We report a series of 4 patients undergoing chronic hemodialysis who developed intravascular infection with Phialemonium curvatum. All isolates were of a distin...

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Bibliographic Details
Published in:Clinical infectious diseases 2004-08, Vol.39 (3), p.373-379
Main Authors: Proia, Laurie A., Hayden, Mary K., Kammeyer, Patricia L., Ortiz, Joanna, Sutton, Deanna A., Clark, Thomas, Schroers, Hans-Josef, Summerbell, Richard C.
Format: Article
Language:English
Subjects:
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Antifungals
Arteriovenous Shunt, Surgical - adverse effects
Ascomycota - classification
Ascomycota - isolation & purification
Biological and medical sciences
Blood
Cardiology. Vascular system
Dialysis
Emergency and intensive care: renal failure. Dialysis management
Endocardial and cardiac valvular diseases
Endocarditis
Female
Fungemia
Fungemia - etiology
Fungemia - microbiology
Fungi
Heart
Heart valves
Human mycoses
Humans
Infections
Infectious diseases
Intensive care medicine
Major Articles
Male
Medical sciences
Mitosporic Fungi - classification
Mitosporic Fungi - isolation & purification
Mycoses
Mycoses - etiology
Mycoses - microbiology
Mycotic sepsis
Phialemonium curvatum
Renal Dialysis
Tissue grafting
Vegetation
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Description
Summary:Phialemonium species are emerging as fungal opportunistic pathogens of humans; infections caused by these fungi often have a fatal outcome. We report a series of 4 patients undergoing chronic hemodialysis who developed intravascular infection with Phialemonium curvatum. All isolates were of a distinct morphological type but were shown by partial ribosomal sequencing to be closely related to reference isolates of P. curvatum. Two patients in our case series died; both developed overwhelming infection associated with fungemia and endocarditis. Recent literature corroborates our experience that Phialemonium infection presents unique diagnostic challenges and that optimal management, particularly with regard to antifungal therapy, is not known.
ISSN:1058-4838
1537-6591
DOI:10.1086/422320