title: Detection of villous conidia of Conidiobolus coronatus in a blood sample by scanning electron microscopy investigation.
abstract: Conidiobolus coronatus is a major insect pathogen belonging to the fungal order Entomophthorales, causing a rare subcutaneous infection of the nasofacial region, resulting in swelling of predominantly the nose, mouth, and perinasal tissue. Later in the course of the infection firm, painless, subcutaneous nodules develop that are attached to the underlying tissues but not to the skin. No morphological studies are available in the literature on the morphology of C. coronatus in vivo and all morphological studies have been conducted on in vitro cultures. Here the authors report on the ultrastructural pathology as seen with a scanning electron microscope (SEM) of villous conidia of C. coronatus, detected in a 37-year-old woman who presented to the casualty department at Pretoria Academic Hospital, South Africa with left-sided facial pain and headache. The diagnosis of C. coronatus was confirmed by LightCycler real-time flourescence PCR technique. Research shows that typically diagnosis of the pathogen is established only on histological examination, and in over 85% of cases cultures for the causative organism is negative. This pathogen has not previously been found in a blood sample and the authors present for the first time the morphology of C. coronatus in blood using the SEM.
authors.affiliation: Department of Oral and Maxillofacial Surgery and Anatomy, University of Pretoria, Pretoria, South Africa.
authors.forename: C F
authors.initials: CF
authors.lastname: Hoogendijk
authors.forename: E
authors.initials: E
authors.lastname: Pretorius
authors.forename: J
authors.initials: J
authors.lastname: Marx
authors.forename: W E P
authors.initials: WE
authors.lastname: Van Heerden
authors.forename: A
authors.initials: A
authors.lastname: Imhof
authors.forename: M
authors.initials: M
authors.lastname: Schneemann
mesh_terms: D000328:Adult; D001769:Blood / Q000469:parasitology*; D020092:Conidiobolus / Q000302:isolation & purification* / Q000472:pathogenicity / Q000648:ultrastructure; D004271:DNA, Fungal / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008855:Microscopy, Electron, Scanning / Q000379:methods; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013172:Spores, Fungal / Q000235:genetics / Q000302:isolation & purification* / Q000648:ultrastructure; D020096:Zygomycosis / Q000097:blood / Q000175:diagnosis* / Q000235:genetics
chemical_list: D004271:DNA, Fungal