Mesh : Administration, Oral Adult Antifungal Agents / administration & dosage pharmacology Base Sequence Blastomyces / drug effects genetics isolation & purification Blastomycosis / microbiology pathology DNA, Fungal / chemistry genetics DNA, Ribosomal Spacer / chemistry genetics Female Genes, Fungal / genetics Humans Hyphae India Itraconazole / administration & dosage pharmacology Microbial Sensitivity Tests Molecular Sequence Data Promoter Regions, Genetic / genetics Sequence Analysis, DNA Spores, Fungal Travel United States

来  源:   DOI:10.3109/13693786.2012.685960   PDF(Sci-hub)

Abstract:
We report a case of disseminated blastomycosis in a female resident of Delhi, who acquired the infection during travel to the USA, which was successfully treated with oral itraconazole. In addition, we present a critical literature review, indicating that blastomycosis is endemic in India but its areas of endemicity, prevalence, and the natural habitat of the etiologic agent, remain undetermined. The diagnosis of blastomycosis was made by examination of Gomori\'s methenamine silver stained sections of tissue obtained from a biopsy of a subcutaneous, abdominal nodular. These studies revealed thick-walled, broad-based budding yeast cells compatible with Blastomyces dermatitidis, and consistent with the isolation of the fungus in cultures inoculated with posterior auricular lymph node aspirate. Microscopically, the isolate had thin, septate hyphae and characteristic spherical to pyriform, smooth-walled microconidia. Its identity was confirmed by conversion to its typical yeast form on pea seed agar at 37°C and by DNA sequencing of ITS and BAD 1 promoter regions.
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