Allergic Fungal Sinusitis Caused by Exserohilum rostratum and Literature Review
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A case of allergic fungal sinusitis (AFS) caused by Exserohilum rostratum, proven by culture and histopathology of the biopsy material, is described. The identity of the isolate was confirmed by sequencing of ITS region of rDNA. To the best of our knowledge, this is the first report of allergic E. rostratum sinusitis from Kuwait and Arabian Peninsula. Ten previously described cases of AFS have been reviewed. The report highlights the emerging importance of E. rostratum as a human pathogen in this region and role of molecular methods in its accurate identification.
KeywordsExserohilum rostratum Fungal sinusitis Molecular diagnosis
Technical support by Sandhya Vayalil and Omar Al-Musallam is thankfully acknowledged.
Compliance with Ethical Standards
Conflict of interest
Authors declare no conflict of interest.
The patient’s informed consent was obtained to publish this report.
- 2.De Hoog GS, Guarro J, Gené J, Fígueras MJ. Atlas of clinical fungi, pilot version of. 3rd ed. Baarn: CD-ROM. Centraalbureau voor Schimmelcultures; 2009.Google Scholar
- 4.Katragkou A, Pana Z-D, Perlin SD, Kontoyiannis DP, Walsh TJ, Roilides E. Exserohilum infections: review of 48 cases before the 2012 United States outbreak. Med Mycol. 2012;2014(52):376–86.Google Scholar
- 6.Khan ZU, Ahmad S, Al-Ghimlas F, Al-Mutairi S, Joseph L, Chandy R, Sutton D, Guarro J. Purpureocillium lilacinum as a cause of cavitary pulmonary disease: a new clinical presentation and observations on atypical morphologic characteristics of the isolate. J Clin Microbiol. 2012;50:1800–4.CrossRefGoogle Scholar
- 8.Padhye AA, Ajello L, Wieden MA, Steinbronn KK. Phaeohyphomycosis of the nasal sinuses caused by a new species of Exserohilum. J Clin Microbiol. 1986;24:245–9.Google Scholar
- 18.Al-Swiahb JN, Al-Ammar A, Al-Dousary SH. Allergic fungal sinusitis in Saudi Arabia. Saudi Med J. 2007;28:1711–4.Google Scholar
- 21.McGinnis MR, Rinaldi MG, Winn RE. Emerging agents of phaeohyphomycosis: pathogenic species of Bipolaris and Exserohilum. J Clin Microbiol. 1986;24:250–9.Google Scholar
- 23.Kohashi S, Toyama T, Hashimoto N, Sakurai M, Kato J, Kikuchi T, Koda Y, Sugita K, Hasegawa N, Yarita K, Kamei K, Okamoto S, Mori T. Sinusitis caused by Exserohilum rostratum after cord blood transplantation for myelodysplastic syndrome: a case report and literature review. Transpl Infect Dis. 2017. https://doi.org/10.1111/tid.12805.Google Scholar
- 24.Centers for Disease Control and Prevention (CDC). Multistate outbreak of fungal infection associated with injection of methylprednisolone acetate solution from a single compounding pharmacy–United States, 2012. MMWR Morb Mortal Wkly Rep. 2012;61:839–42.Google Scholar
- 28.Litvintseva AP, Hurst S, Gade L, Frace MA, Hilsabeck R, Schupp JM, Gillece JD, Roe C, Smith D, Keim P, Lockhart SR, Changayil S, Weil MR, MacCannell DR, Brandt ME, Engelthaler DM. Whole-genome analysis of Exserohilum rostratum from an outbreak of fungal meningitis and other infections. J Clin Microbiol. 2014;52:3216–22.CrossRefGoogle Scholar
- 32.Farmakiotis D, Shirazi F, Zhao Y, Saad PJ, Albert ND, Roilides E, Walsh TJ, Perlin DS, Kontoyiannis DP. Methylprednisolone enhances the growth of Exserohilum rostratum in vitro, attenuates spontaneous apoptosis, and increases mortality rates in immunocompetent Drosophila flies. J Infect Dis. 2014;210(9):1471–5. https://doi.org/10.1093/infdis/jiu289.CrossRefGoogle Scholar
- 33.Nicot J. The ecology of soil fungi: some characteristics of the Microflora in desert sands. Liverpool: Liverpool University Press; 1958. p. 94–7.Google Scholar