XI International Meeting on Paracoccidioidomycosis

XI International Meeting on Paracoccidioidomycosis

Resume:137-4

Poster (Painel)

137-4

Case-report of rhinosinusitis caused by Schizophyllum commune.

Authors:

José V. Tagliarini (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; Sandra M.g. Bosco (IBB - UNESP - Instituto de Biociências de Botucatu - UNESP) ; Carlos A Assis Jr (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; Seizo Yamashita (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; Victor Nakajima (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; Afonso Javarone (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; Eduardo Bagagli (IBB - UNESP - Instituto de Biociências de Botucatu - UNESP) ; Rinaldo Poncio Mendes (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP)

Abstract

Introduction. Infections caused by filamentous basidiomycetes have been rarely reported. This study reports an infection caused by Schizophyllum commune. Case report. A 27-year-old male with a medial deviation of his left eye, erythematous macula and mild itching was treated on December 25, 2009 as conjunctivitis, without improvement. On January 4, 2010 he also presented proptosis of the left eyeball. As cranium MRI showed a solid heterogeneous mass occupying part of the left orbital cavity, a 15-day treatment with itraconazole-ITC 200mg daily was started. On February 6, 2010, the tumor was surgically removed. Tissue mycological examination identified Schizophyllum commune. Molecular identification was performed by amplification of the ITS-5.8S rDNA; PCR products were sequenced and compared by the Blastn program in the GenBank, with a 100% identity to S. commune. On August 7, 2010 he was operated on and amphotericin B deoxycholate was introduced, with improvement. Five days later, due to kidney injury, it was substituted by ITC 200mg orally every 12 hours. After two weeks of treatment he was operated on again to remove the necrotic tissue, which was mycologically negative. The patient has been improving under ITC-treatment, without nasal complaints. Discussion. Few cases of infection caused by S. commune have been reported, most of whom involving the upper respiratory system. Prevalence seems to be higher among females and older patients, differently from our case. We have observed improvement after ITC treatment, as previously reported. However, surgical procedures are mandatory to treat these patients. Conclusion.S. commune must be considered as the etiological agent of rhinosinusitis. However, Aspergillus spp are much more frequent.਀

Keyword: rhinosinusitis, Schizophyllum commune, Molecular identification

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