title: Morphological and Molecular Characterization of Exophiala polymorpha sp. nov. Isolated from Sporotrichoid Lymphocutaneous Lesions in a Patient with Myasthenia Gravis.
abstract: Exophiala species are capable of causing cutaneous and subcutaneous infections in immunocompromised patients. An Exophiala isolate was cultured from a biopsy specimen of a lesion on the forearm of a patient with myasthenia gravis. The patient also had lesions on the palm and distal aspects of the hand, which were successfully treated with a long-term course of itraconazole. A detailed morphological and molecular characterization of the isolate was undertaken. Phylogenetic analysis of the internal transcribed spacer region and portions of the β-tubulin and translation elongation factor 1-alpha genes indicated that the isolate was a novel species closely related to but genetically distinct from species within the Exophiala spinifera clade; the name Exophiala polymorpha sp. nov. is proposed. Morphologically, E. polymorpha most closely resembles E. xenobiotica but it differs in possessing phialides bearing prominent, wide collarettes, and it does not produce chlamydospores.
authors.affiliation: Infectious Diseases, P.C., St. Charles, Missouri, USA.
authors.forename: Lee K
authors.initials: LK
authors.lastname: Yong
authors.affiliation: Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA wiederholdn@uthscsa.edu.
authors.forename: Nathan P
authors.initials: NP
authors.lastname: Wiederhold
authors.affiliation: Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Deanna A
authors.initials: DA
authors.lastname: Sutton
authors.affiliation: Unitat de Micologia, IISPV, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: Marcelo
authors.identifier: http://orcid.org/0000-0001-6832-0252
authors.initials: M
authors.lastname: Sandoval-Denis
authors.affiliation: Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Lindner
authors.affiliation: Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Hongxin
authors.initials: H
authors.lastname: Fan
authors.affiliation: Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Carmita
authors.initials: C
authors.lastname: Sanders
authors.affiliation: Unitat de Micologia, IISPV, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Guarro
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D016000:Cluster Analysis; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D003881:Dermatomycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D005093:Exophiala / Q000145:classification* / Q000166:cytology / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008828:Microbiological Techniques; D008853:Microscopy; D008969:Molecular Sequence Data; D009157:Myasthenia Gravis / Q000150:complications*; D020648:Peptide Elongation Factor 1 / Q000235:genetics; D060446:Phaeohyphomycosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D016896:Treatment Outcome; D014404:Tubulin / Q000235:genetics
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D021903:DNA, Ribosomal Spacer; D020648:Peptide Elongation Factor 1; D014404:Tubulin; D017964:Itraconazole