title: Acremonium kiliense: case report and review of published studies.
abstract: Changes in the spectrum of clinically important fungal infection have been observed in recent years. Acremonium species has been responsible for eumycotic mycetomas but has also been increasingly implicated in systemic fungal diseases. A case of Acremonium kiliense fungemia with proven involvement of the lungs in an allogeneic hematopoietic stem cell patient is reported. A high-resolution computed tomography scan of the lungs showed nodules in both lungs. Multiple cultures of blood demonstrated narrow septate hyphae, cylindrical conidia, and solitary tapering phialides and microconidia that remained grouped in slimy heads. The isolate was identified as A. kiliense based on its morphological characteristics and DNA sequence analysis. Susceptibility testing of the clinical isolate was performed to four antifungal agents. Amphotericin B, fluconazole and itraconazole were found to be inactive in vitro against the isolate; however, it was found to be sensitive to voriconazole. This last drug was indicated, and a high-resolution computed tomography scan of the lungs was normal after 10 days. One year later, the patient was free of symptoms and her blood culture was negative for fungi. Thus, voriconazole was effective in treatment for life-threatening A. kiliense infections. In this work, we performed an overview of worldwide clinical infections caused by A. kiliense.
authors.affiliation: Universidade Paulista-UNIP de Goiás, Goiânia, Brazil.
authors.forename: Milton Camplesi
authors.initials: MC
authors.lastname: Júnior
authors.forename: Adriano
authors.initials: A
authors.lastname: de Moraes Arantes
authors.forename: Hildene Meneses
authors.initials: HM
authors.lastname: Silva
authors.forename: Carolina Rodrigues
authors.initials: CR
authors.lastname: Costa
authors.forename: Maria do Rosário Rodrigues
authors.initials: Mdo R
authors.lastname: Silva
mesh_terms: D000164:Acremonium / Q000145:classification / Q000166:cytology / Q000302:isolation & purification*; D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D005260:Female; D016469:Fungemia / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D008168:Lung / Q000473:pathology; D008172:Lung Diseases, Fungal / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology*; D008828:Microbiological Techniques; D008853:Microscopy; D012340:RNA, Ribosomal, 5.8S / Q000235:genetics; D013902:Radiography, Thoracic; D017422:Sequence Analysis, DNA; D014057:Tomography, X-Ray Computed; D014180:Transplantation; D014184:Transplantation, Homologous
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer; D012340:RNA, Ribosomal, 5.8S