bluuebunny/crossref_metadata_2025_split huggingface dataset:
P128 Chronic pulmonary aspergillosis in a Tuberculosis c enter of Assam—a 2-year study
Authors: K Aishwarya , Nath Reema , Deori Pranjal , Bora Pranami , Goswami Priyam , Phukan Chimanjita 
Published: September 2022

Abstract

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM

Objectives
Chronic pulmonary aspergillosis is a slow and progressive lung disease that occurs in apparently immune-competent patients. Pulmonary tuberculosis is considered to be a major predisposing factor. Early diagnosis of the condition can improve morbidity and mortality. As the number of studies to detect this disease in India is sparse, this study was undertaken in District Tuberculosis center attached to Assam Medical College and Hospital, Dibrugarh to find out the occurrence of chronic pulmonary aspergillosis in treated pulmonary TB patients.

Methods
This prospective hospital-based cross-sectional study was done in Assam Medical College and Hospital, Dibrugarh from December 2015-November 2017. Every consecutive pulmonary TB case after completion of intensive therapy attending the outpatient department with respiratory symptoms was included in the study. Cases were identified with clinical, serological/mycological, and radiological criteria.

Results
A total of 26 cases of CPA were confirmed out of 211 enrolled cases. Positivity rate of CPA in the enrolled patients was 12.3% (95% CI 8.19-17.51%). The hospital-based occurrence rate was found to be 6/1000 (95% CI 3.8-8.5) in the outdoor attendants in DTC, Dibrugarh. Most of the cases (88.46%) were late cases presenting with aspergilloma. Majority (51.72%) of the aspergilloma cases were detected within 5 years of diagnosis of PTB. Very few (15.38%, n = 4) early cases were detected. The sensitivity of the ELISA test (DRG, Germany) was found to be 72.72% as compared with reference Immunocap method used in this study. A section (37.90%) of the patients with fungal ball was seronegative by Aspergillus fumigatus serological test. Two of them were positive for Aspergillus flavus in sputum culture.

Conclusion
A serological test to detect Aspergillus flavus IgG may complement the Aspergillus fumigatus IgG test in detecting CPA. CPA is a neglected disease with a high morbidity and mortality. Routine follow-up protocol for the cavitary patients in tuberculosis center by a sensitive serological test for a minimum period of 5 years may be necessary for early detection of cases in PTB high prevalence countries.
P135 Immunological correlation with clinicomycological aspects of fungal rhinosinusitis during COVID-19 pandemic
Authors: Vashistha Mohan 
Published: September 2022

Abstract

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM

Background and Objectives
To determine the relation between disease spectrum, etiology, and immunological markers of fungal rhinosinusitis.

Material and Methods
Diagnostic nasal endoscopy was used for the collection of sinus and nasal tissue samples which were processed as per standard mycological procedure for microscopy, culture and histopathological examination (HPE). Enzyme-linked immunosorbent assay was used for total IgE, serum IL-6, IL-10, TNF-α levels detection.

Results
Out of 148 samples, 70% were diagnosed as FRS. COVID-19 infection 46.9% was the most common comorbid condition. Use of steroid therapy 46.9% was the most common predisposing factor. Nasal obstruction 62.2% was the most common clinical feature but headache (P-value .002) and eye discharge were statistically significant (P-value .005). KOH mount revealed findings in 84.69% patients in this study. Combination of KOH, HPE, and fungal culture revealed findings in 62.2% cases. Rhizopus arrhizus 27.6% was the most common isolate Aspergillus flavus and Rhizopus arrhizus were statistically significant (P-value .003, .026 respectively). IL-6 59.2% was the most common serological marker raised in this study. PNS imaging revealed that 100% of the patients had single or multiple sinus involvement and maxillary sinus (P-value .038) was significantly associated. Acute invasive fungal rhinosinusitis 75.5% was the most common type of FRS. Mortality was 17.34% in this study.

Conclusion
FRS is an important emerging public health problem and a cause of mortality and morbidity, particularly in immunocompromised patients. Furthermore, in the current scenario of COVID-19 pandemic, FRS has become more fatal and an entity of immediate and grave concern than ever before.
P140 Saksenaea vasiformis infection: case report of extensive abdominal wall necrotizing fasciitis with systematic review and analysis of 64 cases
Authors: K Karthick 
Published: September 2022

Abstract

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

Introduction
Saksenaea vasiformis is a rarely reported Mucorales causing mucormycosis in both immunocompromised and immunocompetent individuals. Due to few reported cases, the clinical characteristics and optimal management strategy for this rare agent are not clearly described. Therefore, we conducted a combined analysis of a case of extensive abdominal wall necrotizing fasciitis from our center with individual patient data extracted from other reports in world literature to give an overview of clinical and demographic profiles as well as factors affecting outcomes in this rare infection.

Methods
We systematically reviewed Medline, Embase, and CINHAL for studies on S. vasiformis infections reported till January 1, 2022, and 57 studies (63 patients) were retrieved. We also describe clinical and demographic characteristics and outcomes of a case of extensive abdominal wall necrotizing fasciitis managed at our institution.

Results
Of the 64 included cases, the majority were reported from India (26.6%). The most common risk factors for infection were accidental trauma (31.3%), health-care-related wounds (14.1%), and animal/insect bites (12.5%). Subcutaneous infection was the most common clinical presentation (60.9%) followed by rhino-orbito-cerebral mucormycosis (ROCM) (14%), necrotizing fasciitis (10%), and disseminated infection (9.3%), pulmonary (3.2%) and osteomyelitis (1.6%). Mortality was observed in 24 (37.5%) patients and healthcare-related injuries were significantly associated with higher mortality (P .001). The use of posaconazole (P .019) and surgical intervention (P: .032) was associated with significantly better survival.
See Figures 1 and 2 below.

Discussion
In this study, we describe the largest compendium of mucormycosis due to S. vasiformis and can be useful in increasing awareness regarding this rare Mucorales in addition to guiding patient management.
P185 Epidemiology of human fusariosis in Greece: results from a 16-year nationwide multicenter survey
Authors: Drogari-Apiranthitou Maria , Mpakosi Alexandra , Siopi Maria , Argyropoulou Athina , Vrioni Georgia , Mamali Vasiliki , Christofidou Myrto , Meletiadis Joseph , Orfanidou Maria , Mastrogiannaki-Marini Alexandra , Skiada Anna , Petrikkos Georgios 
Published: September 2022

Abstract

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

Objectives
Fusariosis in humans comprises a vast array of rare but serious and difficult-to-treat infections, ranging from keratitis and onychomycosis in immunocompetent hosts to life-threatening systemic infections in immunocompromised patients such as those with hematologic malignancies. We aimed to assess the disease burden and baseline epidemiology of fusariosis in Greece.

Methods
From 2004 through 2020 a prospective, nationwide, multicenter survey took place. Demographic and clinical data of fusariosis cases were recorded. Fusarium strains isolated were identified to species level with molecular methods and/or MALDI-TOF MS, and tested for antifungal susceptibility in vitro with the EUCAST methodology.

Results
A total of 54 cases were registered. The most frequent infection was keratitis (n = 21, 39%), followed by bloodstream infections in patients with hematologic malignancy (n = 12, 22.2%). Other infections involved the respiratory tract (n = 3, 5.5%), and sinuses (n = 3, 5.5%) in immunocompromised patients, soft tissues after trauma (n = 5, 9.3%), or diabetic foot (n = 2, 3.7%), and onychomycosis (n = 8, 14.8%). The estimated incidence of invasive Fusarium infections was 2.9 cases/year (0.027 cases/100 000 population). The most frequently isolated species were: F. solani species complex (SC) (n = 13, 24%), F. oxysporum SC (13, 24%), F. fujikuroi SC (n = 12, 22.2%, of which 6 F. verticillioides and 6 F. proliferatum). Other SCs included F. brachygibbosum, F. chlamydosporum, and F. dimerum. In keratitis cases, F. solani was associated with infection secondary to injury with plant material, whereas F. fujikuroi with soft contact lens wear. Fusarium oxysporum was more frequently isolated from nails or soft tissue infections (53.8%). Antifungal MICs were high, with no clear interspecies differences (geometric mean 1.6, 2.5, 3.2 mg/l for amphotericin B, voriconazole, and posaconazole, respectively, median values 2, 4, 8 mg/L, respectively). Fluconazole and the echinocandins showed no activity (MIC &gt;32 mg/l). The most frequently used antifungals were amphotericin B and voriconazole, usually in combination. Treatment failure in keratitis was 38.5%. In patients with hematologic malignancy the crude mortality rate was 71.4%, usually related to the underlying disease. Soft tissue infections complicating diabetic foot or trauma were treated surgically, with favorable outcomes.

Conclusion
Fusarium infections in Greece remain rare, but with considerable morbidity and mortality in the immunocompromised. Early diagnosis and initiation of the appropriate treatment were critical for a successful outcome in keratitis cases, despite moderately high MICs of the antifungals used.
P187 Paratracheal abscess by plant fungus Chondrostereum purpureum. First case report of human infection
Authors: Dutta Soma , Ray Ujjwayini 
Published: September 2022

Abstract

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

Objective
To identify the etiological agent of paratracheal abscess applying molecular techniques.

Methods
A 61-year-old male, plant Mycologist, who specially works with mushrooms presented to the OPD with hoarseness of voice and difficulty in swallowing for the last 3 months. CT scan demonstrated the presence of a right paratracheal abscess. CT-guided aspiration of the abscess was performed. The pus was sent for microbiological evaluation.

Results
The pus culture done on Sabouraud dextrose agar grew a creamy pasty colony with buff-colored pigmentation on reverse side (Fig. 1). On LCB mount preparation it was found to be a yeast-like structure with slender hyphae as shown in Fig. 2. The fungus could not be identified phenotypically, so it was sent to the ‘WHO Collaborating Centre for Reference and Research on Fungi of Medical importance’. It was identified as Chondrostereum purpureum by DNA sequencing. Patient was treated with oral voriconazole following drainage of the pus and the outcome was favorable. The patient denied having worked with such a plant pathogen but he confirmed d that he was working with decaying material and other plant fungi for a long time as part of his research activities.

Conclusion
Silver leaf is a fungal disease of trees caused by the fungus plant pathogen Chondrostereum purpureum. The disease is progressive and often fatal for the plants. It is spread by airborne spores landing on freshly exposed sapwood. No human infection was reported till date. The case report demonstrates the crossover of plant pathogens into humans when working in close contact with plant fungi.
P211 Fungal and bacterial co-infections of the respiratory tract among patients with COVID-19 hospitalized in intensive care units
Authors: Sarvestani Hasti Kamali , Khansari Mahmoud , Rafat Zahra , Abdollahi Alireza 
Published: September 2022

Abstract

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

Backgrounds
The pandemic of COVID-19 has created a global public health crisis. ICU patients with COVID-19 are prone to infections of bacterial and/or fungal origins due to several risk factors. Consequently, the current study was conducted to evaluate the frequency, demographic characteristics, underlying conditions, and etiologic agents of fungal and bacterial co-infections of the respiratory tract among ICU patients with COVID-19 in Iran.

Materials and Methods
From May to October 2020, sputa and endotracheal aspirates were collected from ICU patients hospitalized with COVID-19 who also were suspected of bacterial and/or fungal co-infections according to inclusion criteria. The etiologic agents of bacterial co-infections were identified using the VITEK 2 identification method. For fungal identification, all samples were analyzed by direct microscopy using KOH 10% and culture. Furthermore, all isolates were subjected to the sequencing method.

Results
A total of 73 lung specimens were obtained from patients who met the inclusion criteria. Of these, in 15 cases (20.54%) fungal and/or bacterial co-infections were confirmed. Males were more infected (73.33%) and all of them were between 49 and 79 years. Candida albicans (n = 8, 61.53%) and Klebsiella pneumonia (n = 5, 38.46%) were the most frequent etiologic agents related to fungal and bacterial co-infections, respectively. Pneumonia (n = 15, 100%) and diabetes mellitus (n = 8, 53.33%) were documented as the most prevalent underlying conditions. In the current study, 3 out of 15 patients (20%) died.

Conclusion
The frequency of bacterial co-infections of the respiratory tract in ICU patients hospitalized with COVID-19 was relatively high. According to the results, one of the causes of death in these patients could be a secondary infection.
P215 Investigation of an outbreak of neonatal Candida emia in the NICU of a 300 -bedded hospital in North India
Authors: Kaur Tripta , Garbyal Karan 
Published: September 2022

Abstract

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

Objectives
Neonatal Candidaemia causes significant morbidity and mortality in very low birth weight neonates. We report the occurrence of an outbreak of neonatal Candidaemia due to Candida krusei in the neonatal intensive care unit (NICU) of a 300-bedded hospital in North India.

Methods
A total of 96 blood cultures from 80 neonates admitted in the NICU from October 2020 to April 2021 were received and processed manually in the Microbiology lab. A total of 5 among the 47 yeast isolates were sent to a teaching hospital for identification and antifungal susceptibility testing by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF). Clinical parameters (very low birth weight, gestational age, birth asphyxia, broad-spectrum antimicrobial therapy, intra-uterine growth restriction, and total parenteral nutrition), lab parameters (CRP, platelet count), and patient outcome were evaluated. A total of 26 environmental samples and hand swabs from six health care workers were collected to trace the source of the outbreak. The samples were inoculated on 5% sheep blood agar and MacConkey agar. Regular rounds of the NICU and training sessions were conducted by the infection control team to intensify the infection control measures.

Results
Blood culture results: In all, 57 neonates (71.25%; 57/80) admitted to the NICU had positive blood cultures. A total of 47 blood cultures yielded non-albicans Candida spp. (82.45%; 47/57). The other microorganisms isolated from blood cultures were Pseudomonas aeruginosa (4), MRSA (3), Klebsiella pneumoniae (4) and Acinetobacter baumanni (1). Polymicrobial bloodstream infections were detected in two neonates. All the yeast isolates subjected to MALDI-TOF were identified as Candida krusei and had similar MICs of 0.25, 4, 16, 1, 0.25 and 16 μg/ml for voriconazole, itraconazole, posaconazole, caspofungin, micafungin and fluconazole respectively.
Culture results of environmental sampling: Yeast could not be isolated from any environmental sample and hand swabs of health care workers. However, MRSA was isolated from the hands of one health care worker.
Observation during the infection control rounds:

Conclusion
We report the occurrence of a massive outbreak of neonatal Candidaemia in the NICU of our hospital with a positivity rate of 58.75% (47/80). Identification of yeast and determination of antifungal susceptibility is important for prompt treatment. Though the source of the outbreak could not be traced but intensifying infection control practices could control the outbreak. This study emphasizes the value of educating healthcare workers and regular monitoring of disinfection practices to prevent health-care-associated infections.
P221 Deep dermatophytosis presented as multiple exophytic masses caused by Trichophyton rubrum in immunocompromised patient with rheumatoid arthritis; a case report
Authors: Hong Seong Min , Jang Seung Hee , Ahn Sang Woo , Choi Jong Soo , Shin Jeong Hwan , Kim Jayoung , Seol Jung Eun , Kim Hyojin 
Published: September 2022

Abstract

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

Dermatophyte invades the stratum corneum and infects the skin, nails, and hair, mostly resulting in superficial infection. Deep dermatophytosis involving dermis and subcutaneous layer was rarely reported in immunocompromised state. Herein, we report a case with deep dermatophytosis caused by Trichophyton (T.) rubrum. A 71-year-old woman presented with multiple erythematous exophytic and subcutaneous nodules located on both lower legs. She was taking immunosuppressive agents for rheumatoid arthritis and had taken antifungal agents for tinea pedis and onychomycosis, which was improperly ceased. Histopathologic examination revealed pseudoepitheliomatous epidermal hyperplasia with microabscess formation in epidermis and diffuse granulomatous inflammation consisting of multinucleated giant cells, lymphocytes, neutrophils, and histiocytes in dermis. Imuunohistochemical staining with periodic acid-schiff (PAS) and Gomori methenamine silver (GMS) showed septate and branched fungal hyphae in dermis. Trichophyton rubrum was identified in fungal culture with tissue and confirmed through phylogenetic analysis of internal transcribed spacer (ITS) and large subunit regions (LSU) in ribosomal RNA. Prior to identification of causative organism, her condition deteriorated into septic shock. Amphotericin B was administered empirically for 6 days in order to prevent hematogenous dissemination and skin lesions were simultaneously resolved. Since deep dermatophytosis appears in various clinical manifestations, it is easy to be mistaken for another disease. If treatment is delayed, immunocompetent patients can progress to severe disease courses like hematogenous dissemination, so clinicians should differentiate this disease and conduct treatment at an appropriate time.
P229 Three cases of easy to be misdiagnosed tinea of vellus hair
Authors: Liu Wentao 
Published: September 2022

Abstract

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

Abstract
Vellus hair, also known as fine hair, is generally accepted that tinea of vellus hair is caused by dermatophyte infection of the vellus hair and fungal microscopy reveals the presence of mycelium and/or spores inside and outside the vellus hair. Different types of dermatophytes can cause different types of lesions. Therefore, tinea of vellus hair is easy to underdiagnose or misdiagnose in clinical practice. We report three cases of tinea of vellus hair caused by Microsporum canis. Case 1: A 24-year-old male patient with bilateral erythema with pruritus on the upper extremities for more than 1 year (A1). The patient was diagnosed with tinea of vellus hair by positive dermatoscopy (A2), fungal fluoroscopy (A3), and fungal culture of M. canis. after 9 weeks of treatment (oral itraconazole 0.2 g, 2 times/day, topical amorolfine cream 1 time/day, terbinafine cream 1 time/day), the skin of bilateral forearms basically returned to normal, and it is currently under follow-up. Case 2: A 5-year-old female patient with a rash on the root of the nose for 2 weeks (B1). She was also diagnosed with tinea of vellus hair by positive dermatoscopy (B2) and fungal fluoroscopy (B3) and fungal culture of M. canis. After 2 weeks of treatment (oral itraconazole 0.1 g, 2 times/day, topical terbinafine cream once a day), the lesions improved significantly. After 4 weeks of treatment, a few scales and scabs were still visible on the skin at the root of the nose. After 2 weeks of continued treatment, the patient's skin at the root of the nose was completely restored to normal. Case 3: 2-year-old male patient with a recurrent facial rash with scales for more than 3 months (C1). He was diagnosed with tinea of vellus hair by positive dermatoscopy (C2), fungal fluoroscopy(C3), and fungal culture of M. canis. After 2 weeks of treatment (oral itraconazole 0.1 g once every other day, bifonazole cream 1 time/d), the lesions are in improvement from the previous. And this case is still being followed up. The above three cases have been misdiagnosed as tinea simplex or eczema, and the efficacy of treatment only with topical medicines or short-term oral drugs is not good. Therefore, we take oral medicines and topical medicines for treatment, the course of treatment is long, and there are still spores and hyphae inside and outside the hair many times during the treatment period, so it is recommended that tinea of vellus hair should be treated according to the treatment plan of tinea capitis.
P252 A rare case of fungal liver abscess in an immunocompetent patient from India
Authors: Hallur Vinaykumar , Padmanaban Harishni , Mohanty Srujana , Panigrahi Manas Kumar 
Published: September 2022

Abstract

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

Objectives
To report a case of hepatic abscess caused by Candida albicans, which is a less common cause of hepatic abscesses in a non-onco-hematologic population. Fungal infections represent &lt;2% of the total isolates in pus from hepatic abscesses in patients without onco-hematologic malignancies.

Methods
A 68-year-old adult male diabetic patient came with complaints of fever with chills and rigor and right upper abdominal pain and yellowish discoloration of eyes and urine. His LFT, PT-INR, RFT were deranged. CBC report shows anemia and Leukocytosis. His CECT showed irregular multiseptated hypodense lesions in segment V, VI, VII of liver. Direct and mycological and bacterial culture examination was performed.

Results
Direct examination of pus sample showed budding yeast cells with pseudohyphae and in SDA culture at 37°C it showed white pasty colonies. The species was identified by VITEK 2 system as C. albicans. The MICs obtained of antifungals were (ug/mL): fluconazole (≤0.5); voriconazole (≤0.12); caspofungin (≤0.12); micafungin (≤0.06); amphotericin b (1); flucytosine (≤1). The patient was started on caspofungin and improved symptomatically. Then oral fluconazole was started and continued until the resolution of lesion on imaging during the follow-up.

Discussion
Colonization of the gastrointestinal tract is thought to be the main origin of the dissemination of Candida; neutropenia facilitates the spread of Candida from the gastrointestinal tract to the liver. The likely source of infection is GIT in this case.

Conclusion
We describe a case of fungal liver abscess in an immunocompetent patient caused by Candida albicans which was successfully treated with caspofungin.