title: Pleurostomophora ochracea, a novel agent of human eumycetoma with yellow grains.
abstract: The first yellow-grain fungal mycetoma, in a 60-year-old man from Central Sudan, is reported. Morphological and phylogenetic analysis of the ribosomal small subunit (SSU), large subunit (LSU), internal transcribed spacer (ITS), β-tubulin (BT2), actin (ACT1), and elongation factor (TEF1) genes revealed that the isolate deviated from any known agent of mycetoma; it clustered in the genus Pleurostoma (anamorph genus, Pleurostomophora) in the order Calosphaeriales. The novel species, here named Pleurostomophora ochracea, is characterized by phenotypic features. The species proved to be highly susceptible to itraconazole, ketoconazole, posaconazole, and voriconazole, but not to fluconazole. The fungus was inhibited by caspofungin at 8 μg/ml, while no inhibition was found with 5-flucytosine (MIC > 64 μg/ml). Compared to other members of the genus Pleurostomophora, P. ochracea is slow growing, with a relatively high optimum growth temperature (36 to 37°C). This is the first case of a yellow-grain fungal mycetoma; yellow grains are otherwise of bacterial nature. Our case emphasizes that identification of mycetoma agents by the color of the grain only is not sufficient and may lead to inappropriate therapy.
authors: Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan.
authors: Najwa A
authors: NA
authors: Mhmoud
authors: Sarah Abdalla
authors: SA
authors: Ahmed
authors: Ahmed H
authors: AH
authors: Fahal
authors: G Sybren
authors: GS
authors: de Hoog
authors: A H G
authors: AH
authors: Gerrits van den Ende
authors: Wendy W J
authors: WW
authors: van de Sande
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology; D001203:Ascomycota / Q000166:cytology / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification*; D016000:Cluster Analysis; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D005656:Fungal Proteins / Q000235:genetics; D020459:Genes, rRNA; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008853:Microscopy; D008875:Middle Aged; D008969:Molecular Sequence Data; D008271:Mycetoma / Q000382:microbiology* / Q000473:pathology*; D010802:Phylogeny; D012331:RNA, Fungal / Q000235:genetics; D012337:RNA, Ribosomal, 18S / Q000235:genetics; D017422:Sequence Analysis, DNA; D013397:Sudan; D013696:Temperature
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer; D005656:Fungal Proteins; D012331:RNA, Fungal; D012337:RNA, Ribosomal, 18S