title: Cutaneous hyalohyphomycosis due to Parengyodontium album gen. et comb. nov.
abstract: "Engyodontium album" is an environmental saprobic mould and an emerging opportunistic pathogen able to cause both superficial and systemic infections. In this study, we isolated a mould from the skin lesion biopsy specimen of the right shin in a patient who received renal transplantation for end-stage renal failure with prednisolone, tacrolimus, and azathioprine immunosuppressant therapy. Histology of the skin biopsy showed mild squamous hyperplasia and neutrophilic infiltrate in the epidermis, active chronic inflammation in the dermis, and fat necrosis in the subcutis, with numerous fungal elements within the serum crusts. On Sabouraud glucose agar, the fungus grew as white, cobweb-like, floccose colonies. Microscopically, conidiogenous cells were arranged in whorls of one to seven at wide angles, with zigzag-shaped terminal fertile regions and smooth, hyaline, oval, apiculate conidia. DNA sequencing showed the mould isolate belonged to "E. album" but matrix-assisted laser desorption ionisation-time of flight mass spectrometry (MALDI-TOF MS) failed to identify the isolate. Phylogenetic analyses based on the internal transcribed spacer region, 28S nuclear ribosomal DNA, and β-tubulin gene and MALDI-TOF MS coupled with hierarchical cluster analysis showed that "E. album" is distantly related to other Engyodontium species and should be transferred to a novel genus within the family Cordycipitaceae, for which the name Parengyodontium album gen. et comb. nov. is proposed. Three potential cryptic species within this species complex were also revealed. Antifungal susceptibility testing showed posaconazole and voriconazole had high activities against all clinical P. album isolates and may be better drug options for treating P. album infections.
authors.affiliation: Department of Microbiology.
authors.forename: Chi-Ching
authors.initials: CC
authors.lastname: Tsang
authors.affiliation: Department of Microbiology.|State Key Laboratory of Emerging Infectious Diseases.|Research Centre of Infection and Immunology.|Carol Yu Centre for Infection, the University of Hong Kong, Hong Kong.
authors.forename: Jasper F W
authors.initials: JFW
authors.lastname: Chan
authors.affiliation: Department of Pathology, Queen Elizabeth Hospital, Hong Kong.
authors.forename: Wai-Mei
authors.initials: WM
authors.lastname: Pong
authors.affiliation: Department of Microbiology.
authors.forename: Jonathan H K
authors.initials: JHK
authors.lastname: Chen
authors.affiliation: Department of Microbiology.
authors.forename: Antonio H Y
authors.initials: AHY
authors.lastname: Ngan
authors.affiliation: Department of Microbiology.|Department of Pathology, Queen Elizabeth Hospital, Hong Kong.
authors.forename: Mei
authors.initials: M
authors.lastname: Cheung
authors.affiliation: Department of Pathology, Queen Elizabeth Hospital, Hong Kong.
authors.forename: Christopher K C
authors.initials: CKC
authors.lastname: Lai
authors.affiliation: Department of Pathology, Queen Elizabeth Hospital, Hong Kong.
authors.forename: Dominic N C
authors.initials: DNC
authors.lastname: Tsang
authors.affiliation: Department of Microbiology.|State Key Laboratory of Emerging Infectious Diseases.|Research Centre of Infection and Immunology.|Carol Yu Centre for Infection, the University of Hong Kong, Hong Kong.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China.
authors.forename: Susanna K P
authors.initials: SKP
authors.lastname: Lau
authors.affiliation: Department of Microbiology.|State Key Laboratory of Emerging Infectious Diseases.|Research Centre of Infection and Immunology.|Carol Yu Centre for Infection, the University of Hong Kong, Hong Kong.|Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China.
authors.forename: Patrick C Y
authors.initials: PCY
authors.lastname: Woo
mesh_terms: D000818:Animals; D001706:Biopsy; 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; D006651:Histocytochemistry; D006801:Humans; D060605:Hyalohyphomycosis / Q000175:diagnosis* / Q000382:microbiology*; D006999:Hypocreales / Q000145:classification* / Q000166:cytology / Q000235:genetics / Q000302:isolation & purification*; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008828:Microbiological Techniques; D008853:Microscopy; D008875:Middle Aged; D010802:Phylogeny; D012339:RNA, Ribosomal, 28S / Q000235:genetics; D017422:Sequence Analysis, DNA; D012867:Skin / Q000382:microbiology / Q000473:pathology; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D014404:Tubulin / Q000235:genetics
chemical_list: D004271:DNA, Fungal; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer; D007166:Immunosuppressive Agents; D012339:RNA, Ribosomal, 28S; D014404:Tubulin
keywords: Cordycipitaceae; Engyodontium album; Parengyodontium; Parengyodontium album; cryptic species; cutaneous hyalohyphomycosis