bluuebunny/crossref_metadata_2025_split huggingface dataset:
P217 Pelvic mycoses— an unusual presentation of Rhizopus arrhizus in an ommunocompetent patient
Authors: Khatod Yash , Tr Neetha , Rathod Kirti Kumar , Jain Vidhi , Didel Siyaram , Meena Durgashankar 
Published: September 2022

Abstract

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

Introduction
The rare but increasingly identified infections caused by Mucorales are always detrimental to the patient due to rapid vascular invasion and the need for thorough surgical debridement and definitive antifungal therapy for its cure. Among the Mucorales, maximum cases have been reported among Mucor spp. and Rhizopus spp.
Case: Here we present a case of a 9-year-old immunocompetent child presenting with abdominal pain and distension of 1-month duration followed by swelling of bilateral lower limbs, which was gradual in onset. Ultrasonography of the abdomen and pelvis was done which revealed a pelvic mass on the left side. The child developed acute urinary retention during the hospital stay, which was evaluated to reveal a fistulous connection between urethra and rectum for which transverse colostomy was done. The USG-guided biopsy of the left pelvic mass showed broad aseptate hyphae in Hematoxylin and Eosine staining whereas the KOH mount and culture were negative. The follow-up imaging with CT showed circumferential thickening of the recto-sigmoid region and involvement of the posterior bladder wall. Considering the rapidity of the spread of the infection, injection liposomal Amphotericin B at the dose of 5 mg/kg/d, i.v. was started and given for one week with minimal improvement. However, with this clinical picture and patient profile the diagnosis was strongly suspected to be of Basidiobolomycosis of rectosigmoid region. Treatment also was revised to injection of voriconazole at a dose 8 mg/kg/d, i.v. after loading dose which was later shifted to oral dose after 7 days. A repeat USG-guided biopsy was planned for gene sequencing, which identified the organism as Rhizopus arrhizus. On follow-up, patient showed no clinico-radiological improvement and in view of the mycological evidence, the anti-fungal was changed from voriconazole after 2 weeks to oral isavuconazole at the dose of 200 mg/d following the loading after which significant improvement was achieved and patient was discharged.

Conclusion
Mold infection in the form of spreading rectosigmoid mass in an immunocompetent child usually suggests the picture of Basidiobolomycosis. Treating patients only on clinical grounds without mycological confirmation may lead to overlooking of Mucormycosis and may result in adverse outcomes. The diagnosis of Mucormycosis should always be considered as a differential for a fungal infection in the form of mass lesion in abdomen.
P255 Facial Tinea incognito: a clinical, dermoscopic, and mycological study
Authors: Park Jin , Lee Sang-Kyung , Nam Kyung-Hwa , Yun Seok-Kweon 
Published: September 2022

Abstract

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

Objectives
Tinea incognito (TI) occurring on the face is the most frequently misdiagnosed cutaneous fungal infection; however, very limited information is available on facial TI. This study aimed to characterize the clinical, dermoscopic, and mycological features of facial TI.

Methods
We retrospectively evaluated 38 patients with mycologically proven facial TI at a single institution in Korea between July 2014 and July 2021.

Results
The patients had a mean age of 59.6 ± 20.4 years and showed a slight female predominance (male-to-female ratio, 1:1.5). The most common clinical presentation was an eczema-like pattern (47.3%), followed by rosacea-like (15.7%), psoriasis-like (10.5%), lupus erythematosus-like (10.5%), cellulitis-like (7.8%), and folliculitis-like (7.8%) patterns. The mean duration from disease onset to diagnostic confirmation was 3.4 months. Overall, 78.9% of the patients had accompanying chronic systemic diseases and 57.9% had concurrent tinea infections on other skin sites, mainly on the feet and toenails. Among the 23 (60.5%) cultured specimens, Trichophyton (T.) rubrum was the most frequently detected causative species, followed by Microsporum (M.) canis. T. mentagrophytes and T. verrucosum were also isolated from one case each. On dermoscopy, scales (92.1%) and dilated vascular patterns (arborizing vessels and telangiectasia, 76.3% and 63.2%) were commonly observed in glabrous skin, with follicular patterns such as black dots, broken hairs, and empty follicles. The characteristic trichoscopic features were comma hairs, corkscrew hairs, Morse code-like hairs, and translucent hairs.

Conclusion
The clinical characteristics and distinct dermoscopic features described in this article can aid in the differential diagnosis of facial TI while reducing diagnostic delays and unnecessary treatments.
P273 Diagnostic dilemmas in Pneumocystis pneumonia in case of long COVID -19
Authors: Shah Arpit 
Published: September 2022

Abstract

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

Background
To diagnose Pneumocystis pneumonia in an underlying COVID-19 infection is difficult because of the clinical and radiological indistinguishableness of the presentation.

Case Presentation
We report the case of a 67-year-old male background of type 2 diabetes mellitus (DM) and hypertension (HTN), who presented to the emergency department for severe dyspnea for 6 days. He is treated with corticosteroid and other supportive therapy. Initially, the patient responded with that treatment but suddenly his hypoxia is increasing and getting intubated. All possible causes of deterioration hypoxia were evaluated and came negative. Later stage, BAL was done and immunofluorescence test for PCP came positive. Systemic, cotrimoxazole started and gradually hypoxia improved and extubated.

Conclusion
Pneumocystis and COVID-19 co-infection needs serious consideration, particularly for patients with long-term COVID-19, even if patients do not have conventional risk factors for Pneumocystis pneumonia.
P276 Molecular epidemiology of clinical filamentous fungi in Qatar beyond Aspergillus and Fusarium
Authors: Mohamed Husam Eldin , Houbraken Jos , Boekhout Teun , Almaslaman Muna , Taj-Aldeen Saad 
Published: September 2022

Abstract

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

Objectives
Due to an increasing number of patients at risk, (ie, with a highly compromised immune system and/or receiving aggressive chemotherapy treatment), invasive fungal infections (IFI) are increasingly being reported. They are associated with significantly high mortality rates. Aspergillus spp., particularly A. fumigatus, is the major cause of mold-related IFI around the world followed by Fusarium spp., however, other molds are emerging as human pathogens. The aim of this study was to explore the epidemiology and prevalence of the non-Aspergillus and non-Fusarium molds in human clinical samples over 11 years period in Qatar based tertiary hospital using molecular techniques.

Methods
A total of 91 clinical specimens positive for molds belonging to 90 patients were recorded in about 11 years (September 2003 to November 2014). The isolates were identified based on morphological characteristics and by sequencing the internal transcribed spacer (ITS) gene. To confirm the identifications, a phylogenetic tree based on ITS sequences was constructed.

Results
Most patients were males (72%), 6% were immunocompromised, 12% had IFI, and 7% died within 30 days of diagnosis. The fungal isolates were recovered from a variety of clinical samples, including nails, skin, hair, scalp, nasal cavity, wounds, respiratory samples, body fluids, eye, ear, tissue, abscess, and blood specimens. Dematiaceous fungi were overall the most isolated (33/91, 36%), followed by dermatophytes (25/91, 27%), Mucorales (16/91, 18%), and other hyaline molds (17/91, 19%) (Fig. 1). Curvularia was the most isolated genus (22/91, 24%) and Mucorales were the major cause of IF (5/11, 45.5%) (Table 1). Superficial mycoses were caused by dermatophytes (66%) and non-dermatophytes (34%). Furthermore, rare fungi that are not commonly known to cause human disease were recovered such as Rhytidhysteron rufulum, Subramaniula asteroids, Dothichiza pimprina, and Quambalaria cyanescens.

Conclusion
The current study highlights the epidemiology and spectrum of mold genera, other than Aspergillus and Fusarium, recovered from human clinical samples in Qatar, which can aid in surveillance of uncommon and emerging mycoses other than aspergillosis and fusuriosis.
P296 The role of Candida in acute pancreatitis: A disregarded pathogen
Authors: Srivastava Smriti , Sharad Neha , Ningombam Aparna , Kiro Vandana , Varma Sharin , Malhotra Rajesh , Mathur Purva 
Published: September 2022

Abstract

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

Background
Acute pancreatitis is often complicated by infection of peri-pancreatic necrotic tissue. The infectious etiology commonly involves gram negative enteric bacilli and enterococci. Role of Candida species has remained debatable, despite being isolated in pure or mixed cultures in specimens. We evaluated patients with acute pancreatitis with Candida infection over a duration of 4 years for assessment of risk and prognostic factors.

Objectives
To determine the prevalence and role of Candida infection in patients of acute pancreatitis and ascertain the species distribution and risk factors.

Methods
This study was conducted including adult patients who were admitted to gastro-surgery department and had clinical suspicion of peri-pancreatic fungal infection. Specimens included peri-pancreatic fluid collection obtained intra-operatively or aspirated USG-guided, drain fluid and blood. In addition to aerobic bacterial culture, fungal cultures were performed availing standard mycological procedures. Candida infections were categorized into true and possible as per Chakraborty et al. with some modifications.
True Candida infection of pancreatic tissue was considered when yeast cells were seen and grown in pure or mixed culture from
Possible Candida infection of pancreatic tissue was considered when Candida spp were isolated from
Relevant patient information was obtained from hospital information system. Data were analyzed by SPSS 20 statistical software and MS Excel.

Results
A total of 14 cases were identified amongst which 6/14 (42.9%) had true Candida infection whereas possible Candida infection was seen in 8/14 (57.1%) patients. Out of these, C. tropicalis was the predominant species seen in 9/14 (64.3%) whereas C. albicans was seen in 4/14 (28.6%). One isolate of C. auris was identified. Patients with C. tropicalis infection showed higher mortality (6/9, 66.7%) as compared with patients with other Candida species, in whom 20% (1/5) mortality was noted. Acknowledging limitations inherent to retrospective data extraction, we delineated some of the possible risk factors predisposing to Candida infection, given in Table 1.

Conclusion
Role of Candida species in the pathogenesis of adjacent tissues in case of acute pancreatitis has been neglected in past, but now being increasingly recognized. C. tropicalis is the commonest isolate in our study and carries very high mortality. Screening for Candida spp should be carried out in these patients in view of starting antifungal treatment at the earliest possible so that proper diagnosis and management can be undertaken.
P327 Prevalence of orofacial Mycoses in COVID-19patients: experience from a tertiary care center in Northern India
Authors: Agrawal Sonu Kumari , Tarai Bansidar , Somani Madhuri 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Objective
Due to coronavirus disease (COVID-19) a new group of patients at risk emerged with COVID-19-associated mycoses (CAM). The studies, evaluating the prevalence of CAM are missing in India.

Method
To assess CAM prevalence in a tertiary care hospital in India, we applied direct microscopy, fungal culture, and histopathology on respiratory specimens of 285 critically ill COVID-19 patients admitted between September 2020 and March 2022.

Result
Among the 285 patients, 187 were male, and 98 were female. A total of 34.03% had mucor (33.01% Rhizopus arrhizus;1.02% R. microsporus), 59.51% had Aspergillus (50% Aspergillus flavus; 41.17% A. fumigatus; 2.94% A. terreus; 2.35% A. niger), 3.04% had both (Rhizopus arrhizus + Aspergillus flavus), and 3.01% (Schizophyllum sps 5; Fusarium 1, Paecilomyces variotii 1) had other types of mycosis on fungal smear and culture.

Conclusion
Consistent with others, our findings underline the importance of microbiological/pathological assessment in patients with predispositions for COVID-19-associated mycoses but due to the low prevalence, a routine screening seems not to be indicated currently. However, multicenter studies are desirable for substantiation of findings. A high index of clinical suspicion, diagnosis at an early stage, and use of antifungal agents are essential for a successful outcome.
P334 Fungal infections in patients with COVID-19 in 1-year pandemic 2020-2021 from Cote d'Ivoire
Authors: Koffi David , Toure Andre , Ira Valerie , Kouadjo M. Francis , M'boh Reine , Sylla Karidia , Dosso Mireille 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Background and Objectives
The COVID-19 pandemic has caused significant public health problems both in Côte d'Ivoire and around the world. Among the different causes of morbidity and mortality in COVID-19 patients, the frequency and impact of co-infections are still little studied, especially in patients with acute respiratory distress syndrome (ARDS).
However, people with severe COVID-19 infection are particularly vulnerable to bacterial and fungal infections. This study aims to determine the frequency and susceptibility profile of isolated fungi in severe COVID-19 patients living in west Africa.

Methodology
We conducted a retrospective observational study of COVID-19 patients who were tested for invasive fungal infections (IFI) between 2020 and 2021 in the laboratory of mycology at Pasteur Institute of Cote d'Ivoire.

Results
We received a total of 77 samples (from superficial specimens, deep sites, urine) collected from 35 patients admitted for severe COVID-19. The patients were predominantly female (n = 21, 60%) and had a median age of 54,5 years (range16-79 years).
The mycological analysis for IFI diagnosis showed 20% of samples positive only for yeasts, 66.7% of which were Candida albicans and responsible for 90% of invasive infections in COVID-19 patients. No difference in fungal species was found regarding of the sex, age of the patients, and waves of the pandemic. Antifungal susceptibility testing revealed no resistance to antifungals (fluconazole, voriconazole, itraconazole, amphotericin B, and flucytosine) among Candida isolates.

Conclusion
These data show significant Candidiasis infection associated with the severe form of COVID-19. Given this prevalence of 20%, it is important for clinicians to remain vigilant and take proactive measures to prevent candidemia in patients with COVID-19. The widespread surveillance for fungal co-infections is still essential to reduce mortality associated with COVID-19.
P339 A study of environmental risk factors in chronic rhinosinusitis
Authors: Singha S. Krishna , Mona Henam , Das Shukla , Gupta Neelima , Vaid Lakshmi , Ghosh Chirashree , Singh N.P 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Objectives
Chronic rhinosinusitis (CRS) is a complex disease that incorporates many different conditions. Our aim is to determine the role of environmental risk factors in chronic rhinosinusitis.

Methods
This was a case-control study where forty cases of CRS in the age group of 18-62 years were recruited from the ENT-OPD of UCMS and GTB Hospital, Delhi, a tertiary care hospital, along with 40 age-appropriate healthy controls. Informed and written consent was obtained from all the subjects. Detailed history and examination along with routine blood and radiological investigations were done. Subjective assessment of disease was done using visual analog scales of SNOT 22 questionnaire, environmental questionnaire, and saccharine test. Objective assessment was done using endoscopic grading according to Lund and Kennedy scoring. CT scores were also obtained using Lund and Mackay staging system. Passive air sampling was done by the settle plate method and Anderson six-stage cascade impactor was used for active air sampling. Blood agar and Sabouraud dextrose agar plates were inserted on the six stages of the cascade impactor, which were later incubated at 35°C and 25°C respectively, for 18-24 hours. Bioaerosol concentrations were calculated and MicroScan WalkAway system was used to identify bacterial and fungal growth. The correlation between total bioaerosol concentration and the symptom score was done by spearman's correlation coefficient; a comparison of mean total bioaerosol concentration between the case and control groups was done by Mann-Whitney U-test.

Results
The mean total bio-aerosol concentration from active air sampling in the case group was 458.52 CFU/m3 and 437.63 CFU/m3 in control, which was not significant. It was found to be negatively correlated, but not significant with various parameters in case groups like SNOT 22 score, environmental exposure score, saccharine test, smoking, and endoscopic score. A positive but insignificant correlation was found between total bioaerosol concentration and absolute eosinophilic count and CT score. The mean CFU/100 mm3 counted after passive air sampling between case and control group was 34.03 and 30.88 CFU/100mm3 which was not significant. Fungal growths were mostly Aspergillus flavus and A. Niger followed by Cladosporium spp.

Conclusion
The fungal burden was high in all the households of the case as well as control groups, although, a significant correlation could not be established. The environmental conditions found in this study were found to be conducive to future risk of exacerbation of preexisting fungal infections for which, indoor air quality needs to be monitored.
P346 Pulmonary fungal infection in Sudan, a retrospective study from the Mycology Reference Laboratory
Authors: Ismail Mawahib , Gabr Aida , Zhou Shaoqin , Mahgoub Elsheikh , Ahmed Sarah 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Objectives
Pulmonary fungal infections are life-threatening diseases, if not diagnosed and properly treated can lead to serious complications. In chronic cases, the condition might mimic tuberculosis and may be misdiagnosed. The aim of this retrospective study is to determine the frequency of fungi among the respiratory samples received at the mycology reference laboratory over 5 years period and to provide a view of the burden of pulmonary fungal diseases in the country.

Methods
A total of 713 sputum samples received at the Mycology Reference Laboratory, Khartoum, Sudan, between 2015-2019 were analyzed. These samples were collected from different health care centers in Khartoum state. For every sample, direct microscopy using 20% KOH and methylene blue stain was performed. In addition, cultures were made by inoculating every sample in three tubes of Sabouraud dextrose gar (SDA) containing chloramphenicol. Tubes were incubated at 37°C for 2 and up to 7 days. Isolated fungi were identified phenotypically using the Atlas of Clinical Fungi guidelines.

Results
Out of the 713 samples, 235 (33%) were positive for fungi; both in the direct microscopy and culture. Cultures were identified as Aspergillus species 38 (16%), while 197 (84%) were found to represent Candida species.

Conclusion
Our study showed a high number of fungi is associated with pulmonary conditions in Sudan. Risk factors might include post tuberculosis, Asthma, HIV, and COPD.
P362 Seasonal trend of fungal flora in water of tertiary care hospital in North India
Authors: Mahajan Monika , Kaur Harsimran , Rudramurthy Shivaprakash M , Biswal Manisha , Ray Pallab 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Objectives
The study was conducted to assess the seasonal variation of fungal flora in hospital water of a tertiary care hospital in North India.

Methods
A total of 200 water samples from the main reservoir, overhead and underground tanks, and taps of critical care units of the hospital were collected. The water samples were filtered by membrane filtration technique (0.22 micron) and cultured on dichloran rose-Bengal chloramphenicol agar with and without benomyl. The plates were incubated for upto 15 days and fungal colonies recovered were sub-cultured on Sabouraud Dextrose Agar and identified by phenotypic methods. Yeasts were identified by Matrix Assisted Laser Desorption Ionization Time of Flight (MALDI-TOF-MS).

Results
Mycelial fungi were isolated from 100% of the water samples which included Alternaria, Curvularia, Nigrospora, Penicillium, Aspergillus, Paecilomyces, Scytillidium, and Mycelia sterilia as depicted in Figure 1. Different fungi were prevailing in different water storage units like: Advance eye center— A. fumigatus, A. flavus, Fusarium solani, Alternaria spp. Rhizopus arrhizus, Ustilago spp., mycelia sterilia, Trichosporon spp.; Advance trauma Center—Cladophaialophora spp., Alternaria alternata, Penicillium, spp. A. flavus, A. nidulans, A. fumigatus, F. solani, Rhodotorula spp.: Bone marrow transplant unit— Alterneria alternata, A. niger, A. flavus, A. versicolor, Cladosporium spp., Fonsecaea pedrosoi, Fusarium spp., Nigrospora spherica, Penicillium spp., Rhodotorula spp., Trichosporon ashaii. The seasonal variation of fungal isolation is depicted in Figure 2. Isolation rate of Aspergillus species was 35% in winters, 31% in post-monsoon, 25% in summers. Isolation rate of Penicillium species was 19% in post-monsoon, 16% in winter and 15% in summers. Maximum number of dematiaceous fungi were isolated in summer season with isolation rate of 30% in summers as compared with 21.5% in post-monsoon and 19% in winters. Few yeasts isolated were Rhodotorula, Trichosporon, and Ustilago. Mucorales isolated rarely included Rhizopus, Absidia, Syncephalastrum, and Mucor species. Fungal colony forming units in the water samples ranged from 50 to 450 colony forming units/liter of water.

Conclusion
The distribution of fungi in hospital water showed diversity and seasonal variability. Aspergillus species were isolated in maximum number in the winter season, Penicillium species in post-monsoon season and dematiaceous fungi in the winter season. Water as a source of fungal infection in critical care units, remains a relatively neglected area. Water supply could be a source of nosocomial fungal infections. Improving the quality of water by regular testing for fungal contamination and appropriate action to reduce its burden may reduce the hospital-acquired fungal infections.
P391 Research on molecular diagnostic methods and clinical application of common pathogenic dermatophytes in tinea capitis
Authors: Zhu Peiqiu , Shao Jin , Wang Ruojun , Song Yinggai , Wan Zhe , Li Ruoyu , Yu Jin 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Objective
The main objective of this study was to design and develop a detection system based on qRT-PCR that can quickly and accurately identify the pathogenic fungi of tinea capitis, in order to improve the diagnostic ability of tinea capitis.

Methods

Results

Conclusions
The seven single-tube qRT-PCR assays validated in this study can rapidly detect a variety of pathogenic fungi causing tinea capitis, with a high level of sensitivity and specificity. The combination of qRT-PCR and traditional mycological identification methods can further improve the diagnostic efficacy of tinea capitis.