Patients with severe COVID-19 are at increased risk for invasive fungal infections, which are und... more Patients with severe COVID-19 are at increased risk for invasive fungal infections, which are underestimated. Histoplasmosis reactivation in endemic areas should not be overlooked in this population. In a previous study, seroconversion to anti-histoplasmin antibodies by ELISA was detected in 6/39 (15.4%) patients with severe COVID-19. In this work, samples were further investigated to detect seroconversion to antibodies against the Histoplasma capsulatum 100-kDa antigen (Hcp100) by ELISA. Seroconversion to anti-Hcp100 antibodies was detected in 7/39 patients, of whom 6 also seroconverted anti-histoplasmin antibodies. These results reinforce previous findings that show histoplasmosis as an underdiagnosed fungal entity complicating COVID-19.
BackgroundDiagnosing progressive disseminated histoplasmosis (PDH) is still challenging in many c... more BackgroundDiagnosing progressive disseminated histoplasmosis (PDH) is still challenging in many countries where this disease is highly endemic. Definitive diagnosis is established by culture and/or by cytology/histopathology but both procedures have limited sensitivity and cultures are time‐consuming. Antibodies detection by immunodiffusion has a low sensitivity in immunocompromised individuals. Commercially available antigen detection assays have high sensitivity in PDH cases; however, they are expensive and only performed in few laboratories.AimsTo describe the potential use of a novel ELISA for antibodies testing and a dot blot assay for antigen testing for diagnosing PDH using the recombinant 100 kDa protein of Histoplasma capsulatum (Hcp100) and their polyclonal antibodies as novel reagents, respectively.MethodsSerum and urine samples from a cohort of patients with HIV/AIDS and proven PDH were studied for the detection of anti‐Hcp100 antibodies by ELISA and Hcp100 antigen by do...
Invasive fungal infections as aspergillosis and candidiasis are well-documented complications in ... more Invasive fungal infections as aspergillosis and candidiasis are well-documented complications in critically ill patients with acute respiratory distress syndrome due to COVID-19. However, invasive infections by other molds are rarely reported. We describe a case of invasive fusariosis in a patient with severe COVID-19 with a fatal outcome.
Invasive pulmonary aspergillosis is a complication in critically ill patients with acute respirat... more Invasive pulmonary aspergillosis is a complication in critically ill patients with acute respiratory distress syndrome, especially those with severe coronavirus disease-associated pneumonia. In this study, five cases of presumed invasive pulmonary aspergillosis in one immunocompromised and four immunocompetent patients with COVID-19 in Buenos Aires are described. In all cases, the underlying conditions, clinical presentation, fungal diagnostic tests used and their results, features of the chest scan images, antifungals used and clinical outcomes are detailed.
Clinical cases of coccidioidomycosis are rare in Argentina and are generally found in the large a... more Clinical cases of coccidioidomycosis are rare in Argentina and are generally found in the large arid precordilleran area of the country. This study aims to perform a retrospective review of all coccidioidomycosis cases documented in the country from 1892 to 2009, and to describe those occurring in the last 4 years. One hundred and twenty eight cases were documented in the 117 year-period. Since the original description of the disease in 1892 until 1939, only 6 cases were registered; between 1940 and 1999, 59 (6-14/10 yrs) and the remaining 63 (49% of total cases) occurred in the last decade. The median age of 34 patients registered in 2006-2009 was 31 years (range: 7-89), male/female ratio was 1.3:1 and 12 patients were immunocompromised. Twenty-six cases were confirmed by direct microscopy and/or culture whereas the remaining ones by serology. All isolates were identified as Coccidioides posadasii. Thirty patients lived in a vast geographic region with epicenter in Catamarca Valley...
Information on paracoccidioidomycosis (PCM) in Argentina is fragmented and has historically been ... more Information on paracoccidioidomycosis (PCM) in Argentina is fragmented and has historically been based on estimates, supported only by a series of a few reported cases. Considering the lack of global information, a national multicentric study in order to carry out a more comprehensive analysis was warranted. We present a data analysis including demographic and clinical aspects of a historical series of 466 cases recorded over 10 years (2012–2021). Patients were aged from 1 to 89 years. The general male: female (M:F) ratio was 9.5:1 with significant variation according to the age group. Interestingly, the age range 21–30 shows an M:F ratio of 2:1. Most of the cases (86%) were registered in northeast Argentina (NEA), showing hyperendemic areas in Chaco province with more than 2 cases per 10,000 inhabitants. The chronic clinical form occurred in 85.6% of cases and the acute/subacute form occurred in 14.4% of cases, but most of these juvenile type cases occurred in northwestern Argentin...
The patients with severe COVID-19 are at increased risk for invasive fungal infections, such as i... more The patients with severe COVID-19 are at increased risk for invasive fungal infections, such as invasive pulmonary aspergillosis and candidiasis, which increase morbidity and mortality. However, clinicians should also consider the possibility of reactivating latent Histoplasma capsulatum in patients with severe COVID-19 living within areas of endemicity who have worsening respiratory function or sepsis, even if they do not have classical risk factors for histoplasmosis (e.g., HIV/AIDS). Bearing in mind this scenario, serum samples of 39 non-HIV/AIDS patients from Buenos Aires hospitalized due to severe COVID-19 pneumonia were analyzed for anti-H. capsulatum-specific IgG antibodies by an in-house ELISA. Antibodies against H. capsulatum were detected in the sera of 8/39 patients (20.51%). To exclude the possibility that these antibodies arose from past exposure of these patients to the fungus, paired serum samples obtained after an interval of at least 10 days were evaluated. Of them,...
Acta Bioquimica Clinica Latinoamericana, Jun 1, 2006
Balconi SM y col. mass, the obtained RI was 0.5-4.4 ng/mL, (RI reported by manufacturer: 0.6 -6.3... more Balconi SM y col. mass, the obtained RI was 0.5-4.4 ng/mL, (RI reported by manufacturer: 0.6 -6.3 ng/mL). In myoglobin, the obtained RI for women was 8.3-40.3 ng/mL (RI reported by manufacturer: 14.3-65.8 ng/mL); for men it was . Each laboratory must set up its own RI to guarantee the appropriate representation of specific groups of people and types of samples.
Balconi SM y col. mass, the obtained RI was 0.5-4.4 ng/mL, (RI reported by manufacturer: 0.6 -6.3... more Balconi SM y col. mass, the obtained RI was 0.5-4.4 ng/mL, (RI reported by manufacturer: 0.6 -6.3 ng/mL). In myoglobin, the obtained RI for women was 8.3-40.3 ng/mL (RI reported by manufacturer: 14.3-65.8 ng/mL); for men it was . Each laboratory must set up its own RI to guarantee the appropriate representation of specific groups of people and types of samples.
Revista iberoamericana de micologia : organo de la Asociacion Espanola de Especialistas en Micologia, 2011
BACKGROUND: Onychomycosis accounts for up to 50% of all nail disorders. They can be caused by: ye... more BACKGROUND: Onychomycosis accounts for up to 50% of all nail disorders. They can be caused by: yeasts, dermatophytes and non-dermatophyte moulds. OBJECTIVES AND METHODS: A multicentre study designed to determine the prevalence, mycological test results, aetiological agents, and clinical presentation of onychomycosis was carried out. All fingernail and toenail samples taken during a one year period at 9 diagnostic centres were included. RESULTS: A total of 5,961 samples were analysed, of which 82.3% were from toenails and 17.7% from fingernails. The mean age was 49.7 years, and 66% were females. Direct microscopic examination was positive in 61% of the samples. In adults, 61.2% of toenails were positive using potassium hydroxide (KOH), and 43.7% in cultures. The prevailing aetiological agents belong to the dermatophyte group (82.8%), and distal subungual was the most common clinical form. In fingernails, direct examination showed 59.8% positives, and cultures were positive in 52.9%. ...
ABSTRACT Infectious Disease Global Case ReportsSESSION TYPE: Global Case ReportPRESENTED ON: Tues... more ABSTRACT Infectious Disease Global Case ReportsSESSION TYPE: Global Case ReportPRESENTED ON: Tuesday, October 29, 2013 at 01:30 PM - 02:30 PMINTRODUCTION: Adiaspiromycosis caused by Emmonsia crescens is primarily a respiratory disease affecting small mammals such as rodents. It has also been described, though rarely, as an etiologic agent of pulmonary pathology in humans, become an accidental host by inhaling dust-borne spores (conidia) of the saprophytic soil fungus, potentially leading to death.CASE PRESENTATION: We report the case of a 42 years old man, he was a heavy smoker (100 pack/ years), and works in metal recycling. He consulted for fever associated with weight loss, fatigue and debility. Physical examination revealed hemodynamically stable, chest examination indicated increased work of breathing, wheeze, and coarse crackles at the right side. Cardiovascular and abdominal examinations were normal. Chest CT was performed: right upper lobe with parenchymal loss, in both upper lobes pseudonodular images, bullous emphysema, mediastinal and hilar nodes and widespread bud in tree. His CBC analysis revealed a WBC count of 7000 (normal range: 4.1-10.9×103/μL), hematocrit of 42% (normal range: 41%-53%). Electrolyte levels and renal and liver function test results were normal. Urine microscopy did not reveal any active sediments. Serology for antinuclear antibodies and antineutrophil cytoplasmic antibodies were normal, test HIV negative, alpha 1 antitrypsin levels normal too. Sputum smear was negative for Zielh-Neelsen staining. The bronchoscopy performed did not report any endoluminal lesions. Transbronchial biopsy revealed granuloms. The culture was negative for Mycobacteria. The mycological culture was positive for Emmonsia Crescens. The treatment was initiated with amphotericin B followed by itraconazole with clinical improvements. Four years later he consulted again by self-limited hemoptysis, a new TC was perfomed whitch revealed lung architecture alteration in both upper lobes with cystic areas and dense, micro and macronodular images. Mycological culture from sputum was positive for Emmonsia crescens. We restarted itraconazol treatment with good response.DISCUSSION: Adiaspiromycosis is an unusual pulmonary mycosis. In this case we report a patient with clinical and bacteriological relapse.CONCLUSIONS: It is uncertain if the optimal management of pulmonary adiaspiromycosis should be supportive or if it should consist of antifungal treatment.Reference #1: Barbas Filho JV, Amato MBP, Deheinzelin D, Saldiva PHN, Carvalho CRR. 1990. Respiratory failure caused by adiaspiromycosis. Chest 97:1171-1175Reference #2: England DM, Hochholzer L. 1993. Adiaspiromycosis: an unusual fungal infection of the lung. Am. J. Surg. Pathol. 17:876-886Reference #3: G Anstea, D Sutton. 2012. Adiaspiromycosis Causing Respiratory Failure and a Review of Human Infections Due to Emmonsia and Chrysosporium spp. J Clin Microbiol. 50(4): 1346-1354DISCLOSURE: The following authors have nothing to disclose: Mariano Fielli, Adrian Ceccato, Paula Capece, Gladys Posse, Alfredo Monteverde, Alejandra GonzalezNo Product/Research Disclosure Information.
Patients with severe COVID-19 are at increased risk for invasive fungal infections, which are und... more Patients with severe COVID-19 are at increased risk for invasive fungal infections, which are underestimated. Histoplasmosis reactivation in endemic areas should not be overlooked in this population. In a previous study, seroconversion to anti-histoplasmin antibodies by ELISA was detected in 6/39 (15.4%) patients with severe COVID-19. In this work, samples were further investigated to detect seroconversion to antibodies against the Histoplasma capsulatum 100-kDa antigen (Hcp100) by ELISA. Seroconversion to anti-Hcp100 antibodies was detected in 7/39 patients, of whom 6 also seroconverted anti-histoplasmin antibodies. These results reinforce previous findings that show histoplasmosis as an underdiagnosed fungal entity complicating COVID-19.
BackgroundDiagnosing progressive disseminated histoplasmosis (PDH) is still challenging in many c... more BackgroundDiagnosing progressive disseminated histoplasmosis (PDH) is still challenging in many countries where this disease is highly endemic. Definitive diagnosis is established by culture and/or by cytology/histopathology but both procedures have limited sensitivity and cultures are time‐consuming. Antibodies detection by immunodiffusion has a low sensitivity in immunocompromised individuals. Commercially available antigen detection assays have high sensitivity in PDH cases; however, they are expensive and only performed in few laboratories.AimsTo describe the potential use of a novel ELISA for antibodies testing and a dot blot assay for antigen testing for diagnosing PDH using the recombinant 100 kDa protein of Histoplasma capsulatum (Hcp100) and their polyclonal antibodies as novel reagents, respectively.MethodsSerum and urine samples from a cohort of patients with HIV/AIDS and proven PDH were studied for the detection of anti‐Hcp100 antibodies by ELISA and Hcp100 antigen by do...
Invasive fungal infections as aspergillosis and candidiasis are well-documented complications in ... more Invasive fungal infections as aspergillosis and candidiasis are well-documented complications in critically ill patients with acute respiratory distress syndrome due to COVID-19. However, invasive infections by other molds are rarely reported. We describe a case of invasive fusariosis in a patient with severe COVID-19 with a fatal outcome.
Invasive pulmonary aspergillosis is a complication in critically ill patients with acute respirat... more Invasive pulmonary aspergillosis is a complication in critically ill patients with acute respiratory distress syndrome, especially those with severe coronavirus disease-associated pneumonia. In this study, five cases of presumed invasive pulmonary aspergillosis in one immunocompromised and four immunocompetent patients with COVID-19 in Buenos Aires are described. In all cases, the underlying conditions, clinical presentation, fungal diagnostic tests used and their results, features of the chest scan images, antifungals used and clinical outcomes are detailed.
Clinical cases of coccidioidomycosis are rare in Argentina and are generally found in the large a... more Clinical cases of coccidioidomycosis are rare in Argentina and are generally found in the large arid precordilleran area of the country. This study aims to perform a retrospective review of all coccidioidomycosis cases documented in the country from 1892 to 2009, and to describe those occurring in the last 4 years. One hundred and twenty eight cases were documented in the 117 year-period. Since the original description of the disease in 1892 until 1939, only 6 cases were registered; between 1940 and 1999, 59 (6-14/10 yrs) and the remaining 63 (49% of total cases) occurred in the last decade. The median age of 34 patients registered in 2006-2009 was 31 years (range: 7-89), male/female ratio was 1.3:1 and 12 patients were immunocompromised. Twenty-six cases were confirmed by direct microscopy and/or culture whereas the remaining ones by serology. All isolates were identified as Coccidioides posadasii. Thirty patients lived in a vast geographic region with epicenter in Catamarca Valley...
Information on paracoccidioidomycosis (PCM) in Argentina is fragmented and has historically been ... more Information on paracoccidioidomycosis (PCM) in Argentina is fragmented and has historically been based on estimates, supported only by a series of a few reported cases. Considering the lack of global information, a national multicentric study in order to carry out a more comprehensive analysis was warranted. We present a data analysis including demographic and clinical aspects of a historical series of 466 cases recorded over 10 years (2012–2021). Patients were aged from 1 to 89 years. The general male: female (M:F) ratio was 9.5:1 with significant variation according to the age group. Interestingly, the age range 21–30 shows an M:F ratio of 2:1. Most of the cases (86%) were registered in northeast Argentina (NEA), showing hyperendemic areas in Chaco province with more than 2 cases per 10,000 inhabitants. The chronic clinical form occurred in 85.6% of cases and the acute/subacute form occurred in 14.4% of cases, but most of these juvenile type cases occurred in northwestern Argentin...
The patients with severe COVID-19 are at increased risk for invasive fungal infections, such as i... more The patients with severe COVID-19 are at increased risk for invasive fungal infections, such as invasive pulmonary aspergillosis and candidiasis, which increase morbidity and mortality. However, clinicians should also consider the possibility of reactivating latent Histoplasma capsulatum in patients with severe COVID-19 living within areas of endemicity who have worsening respiratory function or sepsis, even if they do not have classical risk factors for histoplasmosis (e.g., HIV/AIDS). Bearing in mind this scenario, serum samples of 39 non-HIV/AIDS patients from Buenos Aires hospitalized due to severe COVID-19 pneumonia were analyzed for anti-H. capsulatum-specific IgG antibodies by an in-house ELISA. Antibodies against H. capsulatum were detected in the sera of 8/39 patients (20.51%). To exclude the possibility that these antibodies arose from past exposure of these patients to the fungus, paired serum samples obtained after an interval of at least 10 days were evaluated. Of them,...
Acta Bioquimica Clinica Latinoamericana, Jun 1, 2006
Balconi SM y col. mass, the obtained RI was 0.5-4.4 ng/mL, (RI reported by manufacturer: 0.6 -6.3... more Balconi SM y col. mass, the obtained RI was 0.5-4.4 ng/mL, (RI reported by manufacturer: 0.6 -6.3 ng/mL). In myoglobin, the obtained RI for women was 8.3-40.3 ng/mL (RI reported by manufacturer: 14.3-65.8 ng/mL); for men it was . Each laboratory must set up its own RI to guarantee the appropriate representation of specific groups of people and types of samples.
Balconi SM y col. mass, the obtained RI was 0.5-4.4 ng/mL, (RI reported by manufacturer: 0.6 -6.3... more Balconi SM y col. mass, the obtained RI was 0.5-4.4 ng/mL, (RI reported by manufacturer: 0.6 -6.3 ng/mL). In myoglobin, the obtained RI for women was 8.3-40.3 ng/mL (RI reported by manufacturer: 14.3-65.8 ng/mL); for men it was . Each laboratory must set up its own RI to guarantee the appropriate representation of specific groups of people and types of samples.
Revista iberoamericana de micologia : organo de la Asociacion Espanola de Especialistas en Micologia, 2011
BACKGROUND: Onychomycosis accounts for up to 50% of all nail disorders. They can be caused by: ye... more BACKGROUND: Onychomycosis accounts for up to 50% of all nail disorders. They can be caused by: yeasts, dermatophytes and non-dermatophyte moulds. OBJECTIVES AND METHODS: A multicentre study designed to determine the prevalence, mycological test results, aetiological agents, and clinical presentation of onychomycosis was carried out. All fingernail and toenail samples taken during a one year period at 9 diagnostic centres were included. RESULTS: A total of 5,961 samples were analysed, of which 82.3% were from toenails and 17.7% from fingernails. The mean age was 49.7 years, and 66% were females. Direct microscopic examination was positive in 61% of the samples. In adults, 61.2% of toenails were positive using potassium hydroxide (KOH), and 43.7% in cultures. The prevailing aetiological agents belong to the dermatophyte group (82.8%), and distal subungual was the most common clinical form. In fingernails, direct examination showed 59.8% positives, and cultures were positive in 52.9%. ...
ABSTRACT Infectious Disease Global Case ReportsSESSION TYPE: Global Case ReportPRESENTED ON: Tues... more ABSTRACT Infectious Disease Global Case ReportsSESSION TYPE: Global Case ReportPRESENTED ON: Tuesday, October 29, 2013 at 01:30 PM - 02:30 PMINTRODUCTION: Adiaspiromycosis caused by Emmonsia crescens is primarily a respiratory disease affecting small mammals such as rodents. It has also been described, though rarely, as an etiologic agent of pulmonary pathology in humans, become an accidental host by inhaling dust-borne spores (conidia) of the saprophytic soil fungus, potentially leading to death.CASE PRESENTATION: We report the case of a 42 years old man, he was a heavy smoker (100 pack/ years), and works in metal recycling. He consulted for fever associated with weight loss, fatigue and debility. Physical examination revealed hemodynamically stable, chest examination indicated increased work of breathing, wheeze, and coarse crackles at the right side. Cardiovascular and abdominal examinations were normal. Chest CT was performed: right upper lobe with parenchymal loss, in both upper lobes pseudonodular images, bullous emphysema, mediastinal and hilar nodes and widespread bud in tree. His CBC analysis revealed a WBC count of 7000 (normal range: 4.1-10.9×103/μL), hematocrit of 42% (normal range: 41%-53%). Electrolyte levels and renal and liver function test results were normal. Urine microscopy did not reveal any active sediments. Serology for antinuclear antibodies and antineutrophil cytoplasmic antibodies were normal, test HIV negative, alpha 1 antitrypsin levels normal too. Sputum smear was negative for Zielh-Neelsen staining. The bronchoscopy performed did not report any endoluminal lesions. Transbronchial biopsy revealed granuloms. The culture was negative for Mycobacteria. The mycological culture was positive for Emmonsia Crescens. The treatment was initiated with amphotericin B followed by itraconazole with clinical improvements. Four years later he consulted again by self-limited hemoptysis, a new TC was perfomed whitch revealed lung architecture alteration in both upper lobes with cystic areas and dense, micro and macronodular images. Mycological culture from sputum was positive for Emmonsia crescens. We restarted itraconazol treatment with good response.DISCUSSION: Adiaspiromycosis is an unusual pulmonary mycosis. In this case we report a patient with clinical and bacteriological relapse.CONCLUSIONS: It is uncertain if the optimal management of pulmonary adiaspiromycosis should be supportive or if it should consist of antifungal treatment.Reference #1: Barbas Filho JV, Amato MBP, Deheinzelin D, Saldiva PHN, Carvalho CRR. 1990. Respiratory failure caused by adiaspiromycosis. Chest 97:1171-1175Reference #2: England DM, Hochholzer L. 1993. Adiaspiromycosis: an unusual fungal infection of the lung. Am. J. Surg. Pathol. 17:876-886Reference #3: G Anstea, D Sutton. 2012. Adiaspiromycosis Causing Respiratory Failure and a Review of Human Infections Due to Emmonsia and Chrysosporium spp. J Clin Microbiol. 50(4): 1346-1354DISCLOSURE: The following authors have nothing to disclose: Mariano Fielli, Adrian Ceccato, Paula Capece, Gladys Posse, Alfredo Monteverde, Alejandra GonzalezNo Product/Research Disclosure Information.
Uploads
Papers by Gladys Posse