Nosocomial Exophiala jeanselmei pseudoinfection after sonography-guided aspiration of thoracic lesions
Journal
Journal of the Formosan Medical Association
Journal Volume
100
Journal Issue
9
Pages
613-619
Date Issued
2001
Author(s)
Hsu J.-H.
Liaw Y.-S.
Pan Y.-S.
Pan H.-J.
Ho S.-W.
KWEN-TAY LUH
Abstract
Background and purpose: During the period from August 1994 to October 1998, a total of 19 isolates of Exophiala jeanselmei were recovered from 17 patients with various underlying thoracic diseases treated at National Taiwan University Hospital. The purpose of this study was to describe the clinical characteristics of these patients and to determine the microbiologic relatedness of the E. jeanselmei. Methods: Of the 19 isolates, 11 from nine patients were preserved and were identified based on their biotypes as determined by the API ID32C System, their cellular fatty acid profiles by gas-liquid chromatography, their antibiotypes to five antifungal agents by the E-test, and their random amplified polymorphic DNA (RAPD) patterns by arbitrarily primed PCR. Extensive environmental surveillance cultures and cultures from the skin of eight patients and hands of one physician were also performed. Results: One of the 17 patients had E. jeanselmei isolated from cutaneous phaeohyphomycosis (3 isolates), and the other 16 patients had isolations from pleural effusion specimens (15 isolates) or lung mass (1 isolate) following sonography-guided aspiration. The latter 16 patients had no clinical or pathologic evidence of fungal infection. Isolates (clone 1) from aspirated specimens had identical biotypes, antibiotypes, and RAPD patterns, which were different from those of the three isolates (clone 2) from the patient with a cutaneous lesion. All specimens from environmental sources, patients' skin, and the hands of the physician were negative for E. jeanselmei. Conclusion: This series of patients demonstrates the difficulty in identifying the sources of a nosocomial pseudoinfection due to this slow-growing microorganism when isolated from pleural effusion specimens.
SDGs
Other Subjects
antifungal agent; fatty acid; fungal DNA; adult; aged; article; biotypology; clinical article; controlled study; echography; Exophiala; exophiala jeanselmei; female; gas chromatography; hand; hospital infection; human; lipid analysis; liquid chromatography; lung aspiration; male; mycosis; phaeohyphomycosis; physician; pleura effusion; polymerase chain reaction; random amplified polymorphic DNA; skin culture; skin defect; Taiwan; university hospital; Adult; Aged; Biopsy, Needle; Cross Infection; Exophiala; Fatty Acids; Female; Humans; Male; Middle Aged; Mycoses; Random Amplified Polymorphic DNA Technique; Thoracic Diseases
Type
journal article