bluuebunny/crossref_metadata_2025_split huggingface dataset:
P261 Candida species in the bloodstream of patients from a tertiary hospital in southern Brazil
Authors: Wilot Leandre , Benelli Jessica , Basso Rossana , Poester Vanice , Sanchotene Karine , Klafke Gabriel , Xavier Melissa 
Published: September 2022

Abstract

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM
Candidemia in hospitalized patients, especially those admitted to intensive care units (ICUs), is responsible for prolonged periods of hospitalization and antifungal therapy, resulting in higher hospital costs and in high mortality rates. The knowledge of the local prevalence of Candida species in the bloodstream and its susceptibility profile is necessary for appropriate therapeutic and surveillance interventions.

Objectives
This study aims to evaluate the prevalence of candidemia in a tertiary hospital in southern Brazil over a period of around one and a half years, its etiology, and the susceptibility profile of the isolates to antifungal drugs.

Methods
A retrospective study was carried out at the University Hospital of Rio Grande (HU-FURG/EBSERH), which has 218 beds. All cases of candidemia, diagnosed by the isolation of yeasts in blood cultures (automated culture system—Bactec®) between January 2021 and April 2022, were included. Databases were analyzed to collect data regarding the total of blood cultures examined in the same period, as well as the etiology and its susceptibility profile to fluconazole (FLU) and amphotericin B desoxicolate (AMB) (microdilution assay according to M27-A3, CLSI).

Results
During the sixteen months of the study, 368 patients were examined by blood cultures in our hospital, being 216 from ICUs (n = 101 adult; n = 115 neonatal/pediatric). A total of 21 were diagnosed with candidemia, resulting in a prevalence rate of 5.7%. The majority of the candidemia cases (66.6% - 14/21) occurred in ICUs, including pediatric/neonatal ICU (6/115; 5.2%) and adult ICU (8/101; 7.9%). C. albicans was associated with 52.3% of the cases (n = 11). Among the non-albicans species (n = 10), four were identified through MALDI-TOF (C. parapsilosis: n = 3; C. krusei: n = 1). Antifungal susceptibility showed that 62.5% of the non-albicans isolates tested (6/8) were resistant to FLU or AMB.

Conclusions
Candida species are important pathogens associated with sepsis in our hospital, corresponding to around 5% of the bloodstream infections in patients hospitalized, independently of their unit of origin. These data raise awareness of the need for early diagnosis, surveillance of resistance and prevention of this bloodstream infection to optimize the treatment, and promote a better prognosis for critical patients.
P265 Phaeohyphomycosis caused by Rhinocladiella similis mimicking Sporotrichosis
Authors: Taneja Juhi , Ranjan Rahul , Chatterjee Kuhu , Ramesh V , Das Bhabatosh 
Published: September 2022

Abstract

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

Objective
A case of phaeophyphomycosis caused by Rhinocladiella similis with a clinical picture simulating sporotrichosis is described.

Methods
A 34-year-old male patient, employed in a textile factory presented with multiple subcutaneous nodules on the lateral aspect of the dorsum of the left hand and left forearm. There was a history of mechanical trauma 1 year back. On examination, three to four verrucous ulcerative nodules clustered on the dorsum of the left hand were observed. A preliminary diagnosis of sporotrichosis was made and a punch biopsy was performed from the lesion and subjected to KOH examination, fungal culture, and histopathological examination. ITS sequencing was done to confirm the identity of the isolate.

Results
The skin punch biopsy from the lesion on the dorsum of the hand showed marked hyperkeratosis, papillomatosis, parakeratosis, acanthosis, and irregular elongation of rete ridges. No fungal structures and neutrophils were seen. On examination with 40% Potassium hydroxide round yeast-like cells were seen. An initial diagnosis of sporotrichosis was established. After 5 days, white to grayish colonies with aerial hyphae were observed on Sabouraud's dextrose agar which eventually turned greenish black on further incubation. Lactophenol cotton blue (LPCB) mount of the slide culture showed thin, hyaline, septate hyphae with oval conidia arranged in a bottle brush pattern around erect conidiophores and also directly arising from the hyphae. The pathogen was confirmed by ITS sequencing as R. similis. Patient was started on itraconazole 200 mg twice daily for 12 weeks. The patient is on regular follow-up and has shown gradual regression of the lesions indicating response to therapy.

Conclusion
Rhinocladiella similis infections have been reported chiefly from Brazil causing chromoblastomycosis. There have been no reports of infections due to this pathogen from the Indian subcontinent. This report presents the first case of R. similis as an agent of phaeohyphomycosis and calls for the need of a thorough evaluation of these cases so as to manage cases appropriately. It also underlines the need to study and redefine the ecological niche of this pathogen as well as its clinical spectrum.
P275 Dematiaceous fungi as a rare cause of fungal sinusitis in a tertiary care center
Authors: Kumar K.V.P Sai Kiran , Xess Immaculata , Singh Gagandeep , Sachdev Janya , Thakar Alok 
Published: September 2022

Abstract

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

Objectives
To discuss the occurrence and diagnosis of dematiaceous fungi as a causative organisms of fungal sinusitis in patients at a tertiary care center in North India. Since there is limited data on its prevalence, this study was aimed to know the non-Aspergillus causes of fungal sinusitis focusing on the dematiaceous fungi.

Methods
A total of 451 nasal biopsy samples, from the department of pulmonary medicine ward and ICU were received over a period of 3 years, from January 2019 to December 2021. The samples were subjected to conventional mycological diagnostic techniques including direct epifluorescence and light microscopy, culture on solid media and visual identification of growth in culture using lactophenol cotton blue mounts.

Results
Out of 451 samples, no fungi were isolated from 299 samples (66.29%), Aspergillus spp from 63 samples (13.96%), dematiaceous fungi from 10 samples (2.21%), and other fungi from 79 samples (17.5%). Among the dematiaceous fungi isolated, 7 isolates were identified as Alternaria spp. (70%) and 3 isolates were identified as Curvularia species (30%) and described.

Conclusion
Most reported cases of allergic and invasive sinusitis were attributed to Aspergillus spp. However, in the current study, dematiaceous ‘black’ fungi like Alternaria and Curvularia, were also identified as causes of fungal sinusitis in both immunocompromised and immunocompetent individuals, showing an increasing pathogenic spectrum. Hence a high index of clinical suspicion and appropriate laboratory diagnosis assists in initiating appropriate treatment such as surgical debridement, reducing immunosuppression, and antifungal treatment with newer azoles.
P285 Predominance of Trichophyton tonsurans causing tinea capitis: a 12-years retrospective study in north of Iran
Authors: Shokohi Tahereh , Hedayati Mohammad Taghi , Kermani Firoozeh , Moosazadeh Mahmood , Nosratabadi Mohsen , Asadi Sabrieh , Salimi Maryam , Javidnia Javad , Aghili Seyed Reza 
Published: September 2022

Abstract

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

Background
Tinea capitis is a common and endemic fungal infection of the scalp that Trichophyton spp. and Microsporum spp. usually cause. This study aimed to investigate tinea capitis and its etiologic agents for 12 years in northern Iran.

Material Methods
The study is a retrospective analysis involving 11 095 patients referred to the Reference Laboratory of Medical Mycology at Sari, Iran, from July 2009 to April 2022. The skin scraping and hair samples were assessed based on direct microscopy and culture, and causative agents were identified based on macroscopic, and microscopic morphology.

Results
Tinea capitis was confirmed in 209 patients: 157 (75.1%) male and 52 (24.9%) female out of 921 suspected patients with a scalp lesion. The prevalence of tinea capitis in patients who refer to the Reference Laboratory of Medical Mycology varied from 6.1 to 37.5%. In both sexes, a higher rate of tinea capitis was observed in patients younger than 20 years of age. Trichophyton tonsurans (146/209; 69.9%) was the most etiological agent, followed by T. mentagrophytes (13/209; 6.2), T. violaseum (9/209; 4.3), Microsporum canis (3/209; 1.4%), T. verrucosum (2/209; 1%), and T. rubrum (1/209; 0.5%). On direct microscopy examination, endothrix hair invasion in 77.0% cases, ectothrix in 2.3%, septate hyphae in 10.5%, and ecto-endothrix in one case were observed.

Conclusion
In recent decades, the prevalence of tinea capitis caused by anthropophilic fungi has remained high, particularly in younger children. Therefore, it is essential to focus on public and personal health education in this age group to prevent and control the disease.
P286 Histoplasmosis in Sri Lanka
Authors: Sigera Liyanage Shamithra Madhumali , Jayasekera Primali I , Denning David W 
Published: September 2022

Abstract

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

Background
Histoplasmosis is a systemic mycosis caused by Histoplasma capsulatum, a dimorphic fungus. More severe disease has been observed in immunocompromised individuals. Most cases occur in certain endemic regions of the world however it seems to have a much wider global distribution. Histoplasmosis is infrequently recognized in Sri Lanka and the dispersion of information on cases is fragmented.

Method
The comprehensive search of medical literature in the English language through databases from any time to February 2022. Either, culture-proven or histopathologically proven cases were selected as diagnostically confirmed histoplasmosis. Duplicate reports were excluded. All available data on demography, clinical presentation, diagnostic method, management, and clinical outcome were appraised for the reported cases.

Result
One survey of histoplasmin skin sensitivity testing and ten cases of histoplasmosis across Sri Lanka were observed during the above period. A total of 5.7% of histoplasmin positivity had been observed in the survey of histoplasmin sensitivity among 1366 Sri Lankan volunteers of the Western and the Central Provinces in 1969. Most of the patients were reported from the Central province which had the positive histoplasmin test previously. In addition, cases were observed in Southern Province, the Sabragamuwa Province, and the Eastern Province. The majority of affected individuals were adult males (90%) and pediatric patients were not observed. The clinical presentation stretched from oral lesions (the most common presentation), skin lesions, and fever of unknown origin, to adrenal crisis. Disseminated histoplasmosis was diagnosed in 50% of the patients however asymptomatic, acute pulmonary, and chronic pulmonary histoplasmosis was not observed. Both diabetes and betel chewing are likely to be linked with oral histoplasmosis and none of the patients were positive for HIV. Both histopathology and fungal culture methods were used for the diagnosis while the use of antigen and antibody testing were not popular. Both itraconazole and amphotericin B were used for the treatment of the patients with variable outcomes.

Conclusion
Histoplasmosis exists in Sri Lanka. The number of cases could be expected to be much higher than reported along with the increase in at-risk populations. These mandates enhance laboratory diagnostic facilities and increase the awareness of medical professionals in Sri Lanka.
P287 A case of cerebral aspergillosis in Sri Lanka
Authors: Welagedara P.G.R.I.S. , Sigera Liyanage Shamithra Madhumali , Devakanthan B , Jayasekara P.I. 
Published: September 2022

Abstract

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

Introduction
Cerebral aspergillosis is a rare disease entity that is usually associated with high mortality. In accordance with most systemic fungal infections, immunocompromised patients are the predominant victims affected. Nonspecific clinical and radiological features may contribute to difficulty and delay in diagnosis, further contributing to the poor prognosis of cerebral aspergillosis. Obtainment of proper specimens for laboratory diagnosis is a key to make a timely diagnosis that may be lifesaving.

Case Report
A 74-year-old female presented with a frontal headache for 2 weeks’ duration. She had been diagnosed with a low-grade lymphoma and had completed the chemotherapy and high-dose prednisolone 4 weeks prior to this presentation. Other than the frontal headache, which progressed slowly over 2 weeks, she did not disclose any associated symptoms. Physical examination was normal, with neither sign of raised intracranial pressure nor of a CNS infection. Basic investigations revealed no abnormalities, and the white cell count was 7.5 × 109/l and the CRP was 7 mg/l.
An MRI of the brain indicated right frontal sinusitis with a secondary small abscess in the right frontal lobe inferiorly. Therefore, she was treated with parenteral antibiotics for a bacterial infection and was discharged.
The patient presented with a headache again after 3 months. A repeat MRI of the brain revealed an increase in the size of the lesion in the right frontal lobe and the possibility of a cerebral tumor was suggested. A diagnostic biopsy was performed, and the specimen was subjected to fungal studies. The direct microscopic examination revealed fungal filaments and the culture yielded a pure growth of Aspergillus fumigatus.
She was started on intravenous amphotericin B, followed by oral voriconazole. Her headache gradually subsided with antifungal therapy. The duration of therapy was guided by serial radiological imaging, and the patient achieved a complete recovery at the end of 1-year of treatment. She remains asymptomatic to date, after 2 years of treatment completion.

Discussion
Immunocompromised patients with cerebral aspergillosis may present with minimal clinical symptoms and signs. Obtaining a proper specimen for laboratory testing is vital to arrive at a definitive diagnosis. Radiological investigations may play an important role in the diagnosis as well as during the follow-up of a patient with cerebral aspergillosis. Appropriate antifungal treatment for a prolonged duration, with or without neurosurgical intervention and reversal or reduction of immunosuppressive therapy leads to a good prognosis.
P294 A descriptive study of Trichosporon fungemia cases from tertiary care center from north India
Authors: Srinivasan Priya , Kaur Harsimran , Gupta Parakriti , Pandey Abhishek , Paul Raees A , Ghosh Anup , Chakrabarti Arunaloke , Rudramurthy Shivaprakash M 
Published: September 2022

Abstract

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

Objective
Incidence of fungaemia with Trichosporon spp is increasing especially in immunocompromised patients. High mortality of 60% is associated with T. fungemia. Trichosporon species are intrinsically resistant to echinocandins, exhibit high MICs to amphotericin B, and have a propensity to form biofilm necessitating accurate and timely diagnosis. Cases of Trichosporon fungemia are often misdiagnosed and under-reported owing to the difficulties in diagnosis. Here, we report the clinical presentation and outcome of Trichosporon fungemia cases at the tertiary care center from north India.

Methods
This is a descriptive study conducted at the Department of Medical Microbiology, PGIMER, Chandigarh, India. A total of 8 patients who had fungemia due to Trichosporon spp. were included in the study. Trichosporon spp. was identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) with an updated database. Antifungal susceptibility was done using microbroth dilution method recommended by the Clinical and Laboratory Standards Institute (CLSI). Beta-D-glucan (BDG) assay was performed as per the manufacturer's recommendation. Demographic and clinical data along with treatment outcomes of all the patients were noted from medical records.

Results
The average age of presentation of patients diagnosed with Trichosporon fungemia was 44 years and the male to female ratio was 5:3. The underlying conditions included necrotizing pancreatitis (n = 2), infective endocarditis (n = 2) and renal transplant (n = 1) The other risk factors included the use of broad-spectrum antibiotics (n = 7), a central venous catheter (n = 4), and prior surgical procedures (n = 3) BDG was tested in 5 patients and 4 patients had a positive value of &gt;80 pg/ml. A total of 5/8 patients received antifungal treatment. Six patients clinically improved and were discharged while two patients died of refractory shock despite treatment with amphotericin B. Minimum inhibitory concentration of Trichosporon isolates was (range): amphotericin B 0.5-16 μg/ml, fluconazole 0.12-32 μg/ml, voriconazole 0.03-1 μg/ml, itraconazole 0.03-1 μg/ml, and posaconazole 0.03-0.5 μg/ml.

Conclusion
Trichosporon spp. is an opportunistic pathogen causing fungemia in immunocompromised patients. Most of the patients in our study were immunocompetent except for one post-transplant patient. BDG helps in the diagnosis of this infection. This study highlights the need to accurately diagnose Trichosporon infections and perform antifungal susceptibility testing for guiding appropriate management and reducing mortality.
P300 Importance of direct microscopy in respiratory mold infection: a diagnostic dilemma
Authors: Tilak Ragini , Gupta Munesh Kumar , Narwade Prity , Bhatia Mohit 
Published: September 2022

Abstract

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

Introduction
Opportunistic fungal infections are on the rise due to a changing healthcare paradigm worldwide. India is the second most populated country in the world and is experiencing an upward trend in fungal lung diseases.

Objective
Rapid diagnosis of respiratory mold infections by direct microscopy.

Material and Methods
We retrospectively analyzed the mycology of the received respiratory samples; sputum, BAL, or ETT secretion between January 1, 2021 to March 31, 2022. All the samples were processed as per standard mycological procedures. For each sample, two KOH wet mounts were prepared and examined. Samples were inoculated over SDA and blood agar and incubated at 28°0C and 37°C in BOD. Once there was growth, it was processed as per standard protocol.

Results
We received a total of 109 respiratory samples from suspected respiratory fungal infections of which early morning sputum samples 84 (77%) were the predominant followed by BAL samples 25 (23%). Most of the enrolled patients were male 73(67%) with a mean age of 48 years. Among 109 samples, 83 (76%) were shown to be fungal elements by KOH wet mount while 26 (24%) were KOH negative. A total of 53 (48.6%) samples were culture-positive Aspergillus flavus30(27%), was found to be the most common species isolated followed by A. fumigatus 16 (14.6%), miscellaneous11(10%), Aspergillus. species 5 (4.5%), and A. terreus 2 (1.8%).

Conclusion
Considering the findings of KOH mount in our study, we would like to emphasize that this is a very simple, rapid, and cost-effective laboratory method with high diagnostic sensitivity when correlated with clinical findings, radiological findings, and host factors.
Further, it has been found to be very dependable for making decisions to start empirical antifungal therapy early by clinicians.
P304 Epidemiological and clinical characteristics of patients with onychomycosis caused due to Neoscytalidium spp. in two reference centers in Bogotá D.C.
Authors: Álvarez María Alejandra Vanegas , Hernández Oscar Mora , Prada Leticia Sopó , Riveros John Hernández , Osorio Elvis Gómez 
Published: September 2022

Abstract

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

Objective
To describe the sociodemographic and clinical characteristics, diagnostic methods, and therapies received in patients with onychomycosis confirmed due to Neoscytalidium spp, who attended the San José Hospital and the Medical Mycology Laboratory for 1 year, in order to get a better perspective of the disease in our field, enhance its detection and increase early prevention.

Methods
A descriptive cross-sectional observational study was carried out in two centers: San José Hospital and Medical Mycology Laboratory from November 2019 to November 2020; patients of all ages with a confirmed diagnosis of onychomycosis due to Neoscytalidium spp. were included. The cases were identified based on ICD-10 codes and the information was collected from the clinical history, questionnaires, clinical photographs, and additional documents.

Results
A total of 465 cases of onychomycosis were confirmed in the chosen period of time, of which 60 cases were caused due to Neoscytalidium spp. Affecting 31 women and 29 men, with an average age of 48.5 years in both sexes; 85% of these patients lived in Bogota D. C. The mean duration between the onset of the disease and its diagnosis was 3 years, 13% of the patients had a history of chronic disease including thyroid disorders, arterial hypertension, and diabetes mellitus. A total of 98% of the patients had toenail involvement, 88% had 1 to 5 nails involved, 33% of the cases showed mild nail involvement, 20% moderate, and 6% severe. Likewise, 35% of the cases presented dermatomycosis. 43% of the patients reported having received topic and systemic treatment, where there was no improvement in the major of the cases (78%).

Conclusions
Our results support what is reported in the literature regarding risk factors, sociodemographic findings, and difficulty in therapeutic response to the pharmacological measures available to treat this infection; as well as the opinion of certain authors, onychomycosis caused due to non-dermatophyte mold is clinically indistinguishable from that caused by dermatophytes. Therefore, a complete mycological study (direct examination/KOH and culture) should always be performed to identify the causative agent before starting any treatment, since as our study showed, infections due to Neoscytalidium spp. are, in general frequency, the third most common cause of infection in onychomycosis and the first by non-dermatophyte molds.