title: Phaeohyphomycosis due to Alternaria infectoria: a single-center experience with utility of PCR for diagnosis and species identification.
abstract: The term phaeohyphomycosis refers to a rare group of fungal infections characterized by the presence of dark-walled hyphae or yeast-like cells in affected tissues. Herein, we report on the clinical and epidemiological characteristics of six cases of phaeohyphomycosis due to Alternaria spp. that occurred in our hospital over a 30-month period (from January 2008 to June 2010). Interestingly, whereas histopathological examinations were positive and fungal cultures yielded molds in all cases, mycological identification using conventional phenotypic methods was never possible despite prolonged incubation of the isolates. Identification of Alternaria infectoria species complex was obtained for each isolate by amplification and sequencing of the internal transcribed spacer of the ribosomal DNA (ITS rDNA). All patients had favourable outcomes following the introduction of azole-based antifungal therapy. This case series describes the clinical course of these six patients and highlights the utility of molecular identification to help in the identification of the etiologic agent when classical mycological methods have failed.
authors.affiliation: Laboratoire de Parasitologie-Mycologie, Centre Hospitalo-Universitaire de Nantes, Hôtel Dieu, Nantes, France.
authors.forename: Tiphaine
authors.initials: T
authors.lastname: Robert
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Talarmin
authors.forename: Marion
authors.initials: M
authors.lastname: Leterrier
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Cassagnau
authors.forename: Patrice
authors.initials: P
authors.lastname: Le Pape
authors.forename: Isabelle
authors.initials: I
authors.lastname: Danner-Boucher
authors.forename: Olivier
authors.initials: O
authors.lastname: Malard
authors.forename: Anabelle
authors.initials: A
authors.lastname: Brocard
authors.forename: Françoise
authors.initials: F
authors.lastname: Gay-Andrieu
authors.forename: Michel
authors.initials: M
authors.lastname: Miegeville
authors.forename: Florent
authors.initials: F
authors.lastname: Morio
mesh_terms: D000328:Adult; D000368:Aged; D000528:Alternaria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D000935:Antifungal Agents / Q000627:therapeutic use; D001483:Base Sequence; D001706:Biopsy / Q000379:methods; D004271:DNA, Fungal / Q000032:analysis / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000235:genetics; D005260:Female; D006761:Hospitals; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D016533:Mycological Typing Techniques; D060446:Phaeohyphomycosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D017422:Sequence Analysis, DNA
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D021903:DNA, Ribosomal Spacer; D017964:Itraconazole