Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 29, Number 3—March 2023
Dispatch

Emergomyces pasteurianus in Man Returning to the United States from Liberia and Review of the Literature

Jacob PierceComments to Author , Sadia Sayeed, Christopher D. Doern, and Alexandra L. Bryson
Author affiliation: Virginia Commonwealth University Medical Center, Richmond, Virginia, USA

Main Article

Table 2

Reported cases of Emergomyces pasteurianus (formerly Emmonsia pasteuriana) from the literature*

Case (ref) Year Location Patient age, y/sex Patient medical history Clinical features Specimen cultured Treatment Outcome
1 (8)
 1998
 Italy
 40/F
 HIV/AIDS
 Skin ulcerations, weight loss
 Skin biopsy
 Amphotericin
 Died from unrelated cause
2 (9)
 2008
 Spain
 46/M
 HIV (CD4 134 cells/μL, HCV, liver transplant
 Nodular skin lesions (ulcerating), bilateral pulmonary infiltrates, liver failure
 Skin biopsy
 Liposomal amphotericin B (2 wk), decreased immunosuppression
 Died
3 (4)
 2012
 India (Nepal native)
 38/F
 HIV (CD4 <10 cells/μL)
 Nodular skin lesions, weight loss, dyspnea, bilateral pulmonary infiltrates (LUL necrotizing lesion),
 Pulmonary nodule biopsy
 HAART, 2 wk, amphotericin B, then itraconazole, 12 mo
 Survived
4 (10)
 2015
 China
 43/M
 Renal transplant
 Nodular skin lesions (painful, ulcerating), bilateral pulmonary nodules, fungitell negative at first then up to 339 pg/mL
 Skin biopsy
 Amphotericin B, voriconazole, and caspofungin, 2 wk (ongoing)
 Survived
5 (11)
 2015
 China
 30/F
 CMV enteritis, urticaria (on prednisone), HIV negative
 Nodular skin lesions
 Skin biopsy
 Oral voriconazole, 2 mo
Survived
6 (5)
 2016
 Netherlands (Moroccan ancestry)
 62/F
 B cell non-Hodgkin lymphoma, cirrhosis, CKD, T2DM, AIHA; 50 mg/d prednisone
 Nodular skin lesions, dyspnea, RUL nodule
 Skin biopsy
 Posaconazole, decreased steroid dosing, 14 mo
 Survived
7 (5)
 2017
 Netherlands (Iraqi nationality)
 80/M
 B-CLL, CKD
 Encephalopathy, fever, respiratory failure, sepsis
 BAL
 Amphotericin B
 Died
8 (12)
 2019
 Uganda
 38/F
 HIV (CD4 140 cells/μL)
 Nodular skin lesions
 Skin biopsy
 Fluconazole, 6 wk, with clinical worsening followed by itraconazole, 8 wk
 Survived
9 (13)
 2020
 India
 27/F
 HIV/AIDS
 Weight loss, cough, skin lesions
 Skin biopsy
 Amphotericin, 2 wk, itraconazole, 12 mo
 Survived
10 (14) 2020 Hong Kong 61/M Renal transplant Pneumonia Lung biopsy Amphotericin, 8 wk voriconazole, 10 wk Died

*AIHA, autoimmune hemolytic anemia; B-CLL, B cell chronic lymphocytic lymphoma; CKD, chronic kidney disease; CMV, cytomegalovirus; HAART, highly active antiretroviral therapy; HCV, hepatitis C virus; LUL, left upper lobe; RUL, right upper lobe; T2DM, type 2 diabetes mellitus; ref, reference.

Main Article

References
  1. Schwartz  IS, Kenyon  C, Feng  P, Govender  NP, Dukik  K, Sigler  L, et al. 50 years of Emmonsia disease in humans: the dramatic emergence of a cluster of novel fungal pathogens. PLoS Pathog. 2015;11:e1005198. DOIPubMedGoogle Scholar
  2. Dukik  K, Muñoz  JF, Jiang  Y, Feng  P, Sigler  L, et al. Novel taxa of thermally dimorphic systemic pathogens in the Ajellomycetaceae (Onygenales). 2018;60:296–309.
  3. Samaddar  A, Sharma  A. Emergomycosis, an emerging systemic mycosis in immunocompromised patients: current trends and future prospects. Front Med (Lausanne). 2021;8:670731. DOIPubMedGoogle Scholar
  4. Malik  R, Capoor  MR, Vanidassane  I, Gogna  A, Singh  A, Sen  B, et al. Disseminated Emmonsia pasteuriana infection in India: a case report and a review. Mycoses. 2016;59:127–32. DOIPubMedGoogle Scholar
  5. Gast  KB, van der Hoeven  A, de Boer  MGJ, van Esser  JWJ, Kuijper  EJ, Verweij  JJ, et al. Two cases of Emergomyces pasteurianus infection in immunocompromised patients in the Netherlands. Med Mycol Case Rep. 2019;24:5–8. DOIPubMedGoogle Scholar
  6. Dukik  K, Al-Hatmi  AMS, Curfs-Breuker  I, Faro  D, de Hoog  S, Meis  JF. Antifungal susceptibility of emerging dimorphic pathogens in the family Ajellomycetaceae. Antimicrob Agents Chemother. 2017;62:e01886–17.PubMedGoogle Scholar
  7. Maphanga  TG, Britz  E, Zulu  TG, Mpembe  RS, Naicker  SD, Schwartz  IS, et al. In vitro antifungal susceptibility of yeast and mold phases of isolates of dimorphic fungal pathogen Emergomyces africanus (formerly Emmonsia sp.) from HIV-infected South African patients. J Clin Microbiol. 2017;55:1812–20. DOIPubMedGoogle Scholar
  8. Gori  S, Drouhet  E, Guého  E, Huerre  MR, Lofaro  A, Parenti  M, et al. Cutaneous disseminated mycosis in a patient with AIDS due to a new dimorphic fungus [in French]. J Mycol Med. 1998;8:57–63.
  9. Pelegrín  I, Ayats  J, Xiol  X, Cuenca-Estrella  M, Jucglà  A, Boluda  S, et al. Disseminated adiaspiromycosis: case report of a liver transplant patient with human immunodeficiency infection, and literature review. Transpl Infect Dis. 2011;13:507–14. DOIPubMedGoogle Scholar
  10. Feng  P, Yin  S, Zhu  G, Li  M, Wu  B, Xie  Y, et al. Disseminated infection caused by Emmonsia pasteuriana in a renal transplant recipient. J Dermatol. 2015;42:1179–82. DOIPubMedGoogle Scholar
  11. Tang  XH, Zhou  H, Zhang  XQ, Han  JD, Gao  Q. Cutaneous disseminated emmonsiosis due to Emmonsia pasteuriana in a patient with cytomegalovirus enteritis. JAMA Dermatol. 2015;151:1263–4. DOIPubMedGoogle Scholar
  12. Rooms  I, Mugisha  P, Gambichler  T, Hadaschik  E, Esser  S, Rath  PM, et al. Disseminated emergomycosis in a person with HIV infection, Uganda. Emerg Infect Dis. 2019;25:1750–1. DOIPubMedGoogle Scholar
  13. Capoor  MR, Mishra  N, Kolte  S, Singla  G, Gogna  A, Rudramurthy  S, et al. Disseminated Emergomyces pasteurianus infection in India: a case report and a review. Mycopathologia. 2020;185:193–200.PubMedGoogle Scholar
  14. Chik  KK, To  WK. Autochthonous Emergomyces pasteurianus pneumonia in an immunocompromised patient in Hong Kong: a case report. Hong Kong Med J. 2020;26:446–8. DOIPubMedGoogle Scholar

Main Article

Page created: January 12, 2023
Page updated: February 20, 2023
Page reviewed: February 20, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external