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blastomycosis: more evidence for exposure near one's domicile.our previous publications on the epidemiology of blastomycosis suggested that the etiologic organism, blastomyces dermatitidis, may be acquired at home, however this view was challenged in an editorial.200111816782
genetic diversity and transcriptional analysis of the bys1 gene from blastomyces dermatitidis.blastomyces dermatitidis, a pathogenic fungal organism, is able to exist in two different morphologies, a multicellular mycelium or a unicellular yeast, according to temperature, 25 degrees c and 37 degrees c respectively. the switching between morphologies must be accompanied by a cascade of signaling events in which expression of genes responsible for the change of morphology is increased or decreased. bys1, a gene from b. dermatitidis isolate #58, is expressed at high levels in the unicellula ...200111811639
a novel heparin-coated hydrophilic preparation of amphotericin b hydrosomes.amphotericin b hydrosomes (ah; access pharmaceuticals inc) are a novel formulation of hydrophilic, heparin-surfaced nanoparticles (mean diameter 105 nm) containing amphotericin b (amb) designed to target infected sites by local adhesion. ah are cleared in part by a hepatobiliary mechanism, which results in a reduction of amb concentration in major organs by about 50% in 24 h. in mice with pulmonary blastomycosis, unlike fungizone (bristol-myers squibb inc), a deoxycholate micellar formulation of ...200111566003
rapid identification of dimorphic and yeast-like fungal pathogens using specific dna probes.specific oligonucleotide probes were developed to identify medically important fungi that display yeast-like morphology in vivo. universal fungal primers its1 and its4, directed to the conserved regions of ribosomal dna, were used to amplify dna from histoplasma capsulatum, blastomyces dermatitidis, coccidioides immitis, paracoccidioides brasiliensis, penicillium marneffei, sporothrix schenckii, cryptococcus neoformans, five candida species, and pneumocystis carinii. specific oligonucleotide pro ...200111574564
paracoccidioides brasiliensis in a postpartum pap smear. a case report.there are several reported cases that describe female genital tract infections with opportunistic fungi, such as blastomyces dermatitidis, coccidioides immitis, aspergillus flavus, cryptococcus neoformans and mucor. we describe a case of paracoccidiodomycosis limited to the uterine cervix. to the best of our knowledge, no such case has been described before in the english-language literature.200111213509
selective expression of the virulence factor bad1 upon morphogenesis to the pathogenic yeast form of blastomyces dermatitidis: evidence for transcriptional regulation by a conserved mechanism.most dimorphic fungal pathogens grow as non-pathogenic moulds in soil and convert to pathogenic yeast in the host, suggesting that virulence factors are upregulated during phase transition. such factors have been difficult to identify. we analysed bad1 (formerly wi-1), a virulence factor in the dimorphic fungus blastomyces dermatitidis, for expression in yeast and mycelial morphotypes. bad1 was expressed in yeast but not in mycelia of north american strains of b. dermatitidis, and this expressio ...200111251809
in situ hybridization for the identification of yeastlike organisms in tissue section.the identification of yeast and yeastlike organisms in tissue sections can be very difficult. biopsy tissues may be limited, with only occasional organisms present. in addition, several common species have overlapping histologic features. deoxyribonucleic acid probes were designed to detect both the 18s and 28s ribosomal ribonucleic acid sequences of five fungal organisms with a high degree of specificity for each fungus. each of these organisms--blastomyces dermatitidis, coccidioides immitis, c ...200111277390
[cutaneous blastomycosis revealing a corticoadenoma].blastomycosis is an uncommon chronic granulomatosis caused by blastomyces dermatitidis. we present a case with a skin localization that disclosed malignant corticoadenoma.200111319392
public health response to 2 clinical cases of blastomycosis in colorado residents.we summarize the public health response after the identification of 2 cases of pneumonia caused by blastomyces dermatitidis infection in colorado residents. the response to these cases emphasizes the need for physicians to add fungal infection to the list of differential diagnoses for patients who have refractory pneumonia, even those who live in areas of nonendemicity.200111340548
the wi-1 adhesin blocks phagocyte tnf-alpha production, imparting pathogenicity on blastomyces dermatitidis.the wi-1 adhesin is indispensable for pathogenicity of blastomyces dermatitidis and is thought to promote pulmonary infection by fixing yeast to lung tissue and cells. recent findings suggest that wi-1 confers pathogenicity by mechanisms in addition to adherence. here, we investigated whether wi-1 modulates host immunity by altering production of pro-inflammatory cytokines. production of tnf-alpha in lung alveolar fluids of mice infected with b. dermatitidis was severalfold higher for wi-1 knock ...200111160330
pathological case of the month. blastomyces dermatitidis. 200111177071
acquired immunodeficiency syndrome-related blastomycosis in an unusual geographic location.blastomycosis is a fungal infection acquired via inhalation of blastomyces dermatitidis. the majority of cases occur in central, southeastern, and mid-atlantic areas of the united states. we report the case of a 42-year-old veteran infected with the human immunodeficiency virus who presented in e1 paso, texas, with a dry cough, fever, and recent weight loss. we review the clinical and epidemiologic features of blastomycosis. diagnostic criteria and pharmacologic management are discussed. active ...200111725316
studies on the molecular ecology of blastomyces dermatitidis.the microecology of blastomyces dermatitidis, the dimorphic etiologic agent of the potentially fatal systemic fungal infection, blastomycosis, is not well defined. blastomyces dermatitidis may occur periodically at natural sites, perhaps aided by rotting organic material, animal droppings and physical changes. semi-quantitative growth studies of b. dermatitidis on 2% agar plates determined the ability to utilize or tolerate a variety of substrates including simple and complex molecules as carbon ...200111761145
role of glucan and surface protein bad1 in complement activation by blastomyces dermatitidis yeast.our previous studies showed that blastomyces dermatitidis yeast activates the human complement system, leading to deposition of opsonic complement fragments onto the yeast surface. this report examines the influence of altered surface expression of glucan or bad1 protein (formerly wi-1) on the yeast's ability to activate and bind c3. compared to the wild type, a glucan-deficient mutant yeast delayed initiation of c3 deposition and reduced c3-binding capacity by 50%. linkage of baker's-yeast beta ...200111705933
immunoreactivity of the fungal cell wall.the cell wall is the major fungal structure involved in the interaction with the host and most of the immunological effects observed with intact fungal cells have been reproduced with cell-wall components. as a result of the exposure to fungal antigens, most individuals develop both cellular and antibody responses intended to limit the invasiveness or to eradicate the fungus from the infected tissues. however, a number of fungi including candida albicans, cryptococcus neoformans, blastomyces der ...200111800264
blastomyces dermatitidis with large yeast forms.yeast forms of blastomyces dermatitidis typically range from 8 to 20 microm in largest diameter. we report a rare case of primary pulmonary blastomycosis with an unusual morphology, in which we found significant numbers of large yeast forms ranging from 30 to 35 microm in diameter. to our knowledge, this is only the second reported case of giant forms of b dermatitidis. we also review the literature and discuss the possible association of this unusual morphology with immunosuppression in general ...200111300940
viability, morphological characteristics and dimorphic ability of fungi preserved by different methods.the viability, morphological characteristics and dimorphic ability of fungi were evaluated. strain subcultures were maintained under mineral oil and in soil for different periods of time, ranging from 49 to eight years. of the 16 blastomyces dermatitidis strains, four maintained viability and were able to complete the dimorphic process to the m phase producing a large amount of conidia, but were unable to form y cells at 36 degrees c. of the 15 histoplasma capsulatum var. capsulatum strains, onl ...200115496128
molecular epidemiology of blastomyces dermatitidis.the inhalation of conidia of blastomyces dermatitidis, a fungus found in soil, causes disease in humans and animals. we studied the genetic diversity of this pathogen by extracting dna yeasts and analyzing them with a polymerase chain reaction (pcr)-based typing system we developed, which used restriction fragment analysis of amplicons from the regions between the rdna repeats and allowed us to class isolates into 3 major groups. strains were further differentiated by use of pcr fingerprinting w ...200010671337
cell wall biogenesis of blastomyces dermatitidis. evidence for a novel mechanism of cell surface localization of a virulence-associated adhesin via extracellular release and reassociation with cell wall chitin.pathogenic yeast of blastomyces dermatitidis express a surface protein adhesin, wi-1. due to the crucial role of wi-1 in adherence and disease pathogenesis, we investigated how the protein localizes to the surface of b. dermatitidis. wi-1 released extracellularly by wild-type yeast coated the surfaces of co-cultured knockout yeast within 3 h of incubation, implying that secreted wi-1 provides a pathway for loading the protein onto the yeast cell wall. in radioligand binding assays, purified wi-1 ...200010713109
disseminated blastomycosis in two california sea lions (zalophus californianus).two captive california sea lions (zalophus californianus) from different facilities were diagnosed with disseminated blastomycosis. the first, a 12-yr-old male, died after a 3-wk history of progressive anorexia and lethargy. gross examination revealed acute jejunitis with focal perforation and associated peritonitis, along with severe purulent bronchopneumonia. the second, a 15-yr-old female, was euthanized after a 2-wk history of severe cutaneous ulceration and declining clinical condition. gro ...200010982135
antibodies to antigens of histoplasma, blastomyces and candida in hiv patients and carriers in nigeria.serum samples from 60 subjects with confirmed hiv-1 infection including 28 aids patients and 32 carriers were examined by immunodiffusion for precipitating antibodies to antigens of histoplasma, blastomyces and candida. seven of the subjects, four patients and three carriers, showed antibodies to histoplasmin prepared from mycelial cultural filtrate of histoplasma capsulatum var. capsulatum and h. capsulatum var. duboisii although without any clinical signs of classical or african histoplasmosis ...200010948814
interleukin 12 as an adjuvant to wi-1 adhesin immunization augments delayed-type hypersensitivity, shifts the subclass distribution of immunoglobulin g antibodies, and enhances protective immunity to blastomyces dermatitidis infection.cell-mediated immunity is pivotal in host resistance to blastomyces dermatitidis infection. immunization of mice with the wi-1 adhesin enhances resistance against experimental pulmonary infection but elicits features of a mixed t-helper-cell immune response. immune mice acquire delayed-type hypersensitivity (dth) but also high titers of wi-1-specific immunoglobulin g1 (igg1) and igg2b, a result indicative of t-helper-2 cellular immunity. we report that interleukin-12, used as an adjuvant for wi- ...200011083850
t-cell epitopes and human leukocyte antigen restriction elements of an immunodominant antigen of blastomyces dermatitidis.humans infected with the dimorphic fungus blastomyces dermatitidis develop strong t-lymphocyte responses to wi-1, an immunodominant antigen that has been shown to elicit protective immunity in mice. in the present study, the t-cell epitopes of wi-1 and human leukocyte antigen (hla) restricting elements that display them were investigated. peripheral blood mononuclear cells (pbmc) from 37 patients with a confirmed history of blastomycosis were tested for a response to wi-1 in primary proliferatio ...200010639410
expanding epidemiology of blastomycosis: clinical features and investigation of 2 cases in colorado.on the basis of case reports of blastomycosis, blastomyces dermatitidis is widely accepted to be endemic in the central united states in and around the ohio and mississippi river valleys. blastomycosis also occurs in parts of canada and in the southeastern united states. however, there has been no large-scale skin testing, and the environmental range of b. dermatitidis may have been underestimated. we describe 2 immunocompetent patients with blastomycosis acquired while working in the front rang ...200010722448
histopathological evidence of north american blastomycosis in italy: report of two cases.no clinical reports of blastomycosis in italy have been published until now. we here report two cases of histologically diagnosed, unexpected cutaneous involvement in patients, aged 78 and 52 years, living in north italy and never having been abroad. the histological differential diagnosis between blastomycosis and other fungal pathogens is discussed. even in the absence of culture the present cases can confidently be considered as genuine examples of blastomyces dermatitidis infection in italy.200010843414
dimorphism in histoplasma capsulatum and blastomyces dermatitidis. 200010863674
pulmonary infection caused by gymnascella hyalinospora in a patient with acute myelogenous leukemia.we report the first case of invasive pulmonary infection caused by the thermotolerant ascomycetous fungus gymnascella hyalinospora in a 43-year-old female from the rural midwestern united states. the patient was diagnosed with acute myelogenous leukemia and treated with induction chemotherapy. she was discharged in stable condition with an absolute neutrophil count of 100 cells per microliter. four days after discharge, she presented to the cancer clinic with fever and pancytopenia. a solitary p ...200010618119
diploid strains of the pathogenic basidiomycete cryptococcus neoformans are thermally dimorphic.cryptococcus neoformans is an opportunistic human pathogenic fungus with a defined sexual cycle. clinical and environmental isolates of c. neoformans are haploid, and the diploid stage of the lifecycle is thought to be transient and unstable. in contrast, we find that diploid strains are readily obtained following genetic crosses of congenic matalpha and mata strains. at 37 degrees c, the diploid strains grow as yeast cells with a single nucleus that is larger than a haploid nucleus, contains a ...200010882532
comparison of an established antibody sandwich method with an inhibition method of histoplasma capsulatum antigen detection.the histoplasma antigen immunoassay utilizes an antibody sandwich method that provides a rapid and reliable means of diagnosing the more severe forms of histoplasmosis. inhibition assays have been developed for antigen detection and offer at least one potential advantage, namely, reduced antibody requirements. we have developed an inhibition assay using the polyclonal antibody employed in our standard sandwich assay. urine and serum specimens from patients with culture-proven histoplasmosis and ...200010921949
small subunit ribosomal dna sequence shows paracoccidioides brasiliensis closely related to blastomyces dermatitidis.the similarities of paracoccidioidomycosis and blastomycosis are highly suggestive of a close relation of the two etiological agents. whereas the agent of the first disease is exclusively endemic in latin america, the agent of the latter one is endemic in north america and africa. in symptomatic travelers visiting both areas of endemicity, differentiation of the diseases might be impossible, even though therapy and prognosis for these two diseases differ significantly. in order to identify diffe ...200010970355
meningoencephalitis due to blastomyces dermatitidis: case report and literature review.infection of the central nervous system by blastomyces dermatitidis is a rare cause of meningoencephalitis. the existence of exclusive clinical infection of the meninges in the absence of pulmonary or other foci of infection has been debated. we describe a 20-year-old man presenting with meningoencephalitis caused by b dermatitidis. blastomycotic infection was confirmed by isolation of the organism from brain tissue obtained at biopsy. magnetic resonance imaging demonstrated progressive enhancem ...200010761497
investigation of anti-wi-1 adhesin antibody-mediated protection in experimental pulmonary blastomycosis.infection with blastomyces dermatitidis elicits strong antibody responses to the surface adhesin wi-1. the antibodies are directed chiefly against the adhesive domain, a 25-amino-acid repeat. tandem-repeat-specific monoclonal antibodies (mabs) were studied for their opsonic activity in vitro and their capacity to adoptively transfer protection in murine experimental blastomycosis. mabs to wi-1 enhanced binding and entry of b. dermatitidis yeasts into j774. 16 cells but did not enhance killing or ...200010823774
canine antibody response to blastomyces dermatitidis wi-1 antigen.to assess whether dogs with blastomycosis produce antibodies against the wi-1 and a-antigens of blastomyces dermatitidis and whether the antibodies are useful in serodiagnosis.200010803652
in vitro activities of voriconazole, itraconazole, and amphotericin b against blastomyces dermatitidis, coccidioides immitis, and histoplasma capsulatum.the in vitro activity of voriconazole was compared to those of itraconazole and amphotericin b against the mold forms of 304 isolates of three dimorphic fungi, blastomyces dermatitidis, coccidioides immitis, and histoplasma capsulatum. mics were determined by a broth microdilution adaptation of the national committee for clinical laboratory standards m27-a procedure. rpmi 1640 medium was used for tests with voriconazole and itraconazole, whereas antibiotic medium 3 with 2% glucose was used for a ...200010817743
correlation of susceptibility of immature mice to fungal infection (blastomycosis) and effector cell function.immature mice are highly susceptible to blastomycosis, which is similar to other mycoses and has parallels in humans. the murine susceptibility is noteworthy in that it persists beyond the development of resistance to other, nonfungal pathogens and the maturation of most immune functions. as the susceptibility to blastomycosis appeared to be related to an early event after infection, primary effector cell function was studied. we found that peritoneal inflammatory cells, enriched for neutrophils ...200011083802
mutation of the wi-1 gene yields an attenuated blastomyces dermatitidis strain that induces host resistance.systemic fungal infections are becoming more common and difficult to treat, and vaccine prevention is not available. pulmonary infection with the dimorphic fungus blastomyces dermatitidis often progresses and requires treatment to prevent fatality. we recently created a recombinant strain of the fungus lacking the wi-1 adhesin and pathogenicity. we show here that administration of viable yeast of this attenuated strain vaccinates against lethal pulmonary experimental infection due to isogenic an ...200011104791
blastomycosis: organ involvement and etiologic diagnosis. a review of 123 patients from mississippi.blastomycosis can only be diagnosed through the identification of the yeasts of blastomyces dermatitidis in body fluids, tissues, or cultured material. the charts from 123 patients treated for blastomycosis at the university of mississippi medical center from january 1980 through may 2000 were reviewed to determine the role of wet preparation, cytology, histology, and culture in diagnosing this fungal disease. cytology uncovered the etiologic agent in 56.1% of all cases and in 71.8% of pulmonary ...200011149972
mycoses associated with aids in the third world.despite advances in diagnosis and treatment, the epidemiological status of the human immunodeficiency virus (hiv) infection is far from under control in most of the developing world. sub-saharan africa, southeast asia and india show increased rates of new infections. in latin america and the caribbean there were 1.6 million estimated cases of hiv-infected patients at the end of 1997. fungal diseases have been one of the most relevant diagnoses in relation to the acquired immunodeficiency syndrom ...200011204155
molecular basis of pathogenicity in blastomyces dermatitidis: the importance of adhesion.an understanding of the molecular bases of pathogenicity in blastomyces dermatitidis and related systemic dimorphic fungi has been limited until recent years. yeast cells of b. dermatitidis display an adhesion promoting protein termed wi-1. recent studies entailing homologous gene targeting and mutation of wi-1 have provided null mutants at this locus and demonstrated the crucial role of the wi-1 adhesin in pathogenesis of blastomycosis. ongoing studies are pointing to a link between phase-speci ...200010972490
a new pcr primer for the identification of paracoccidioides brasiliensis based on rrna sequences coding the internal transcribed spacers (its) and 5 x 8s regions.internal transcribed spacer (its) genes including the 5.8s ribosomal (r)rna of paracoccidioides brasiliensis were amplified and the dna sequences were determined. based on a comparison of the sequence information, a new polymerase chain reaction (pcr) primer pair was designed for specific amplification of dna for p. brasiliensis. this primer pair amplified a 418-bp dna sequence and was 100% successful in identifying 29 strains of p. brasiliensis (including the reference strains) isolated from th ...200010975701
extracorporeal membrane oxygenation for overwhelming blastomyces dermatitidis pneumonia. 199911056730
fluorine-18 fluorodeoxyglucose accumulation in blastomyces dermatitidis-associated inflammation in a dog.whole-body positron emission tomography (pet) imaging with fluorine-18 fluorodeoxyglucose (f-18 fdg) was performed in a dog with blastomycosis. prior to pet scanning, blastomycotic lesions had been identified in both eyes, lungs, and tracheobronchial lymph nodes. increased f-18 fdg uptake was present in these sites in addition to multiple organs without previous clinical evidence of disease. all sites of f-18 fdg uptake were confirmed histologically to be blastomycotic granulomas. f-18 fdg-pet s ...199914516533
targeted gene disruption reveals an adhesin indispensable for pathogenicity of blastomyces dermatitidis.systemic fungal infections are becoming more common and difficult to treat, yet the pathogenesis of these infectious diseases remains poorly understood. in many cases, pathogenicity can be attributed to the ability of the fungi to adhere to target tissues, but the lack of tractable genetic systems has limited progress in understanding and interfering with the offending fungal products. in blastomyces dermatitidis, the agent of blastomycosis, a respiratory and disseminated mycosis of people and a ...199910209038
yeast tissue phase of emmonsia pasteuriana inoculated in golden hamster by intratesticular way.the scope of our study was to present an experimental model reproducing the dimorphic yeast-like population (as for histoplasma capsulatum, blastomyces dermatitidis) similar to that observed in the cutaneous biopsy of an italian woman who had never traveled abroad, being intravenous drug user and hiv positive for 10 years, finally infected with the new dimorphic fungus emmonsia pasteuriana. experimental inoculation was unsuccessful by intraperitoneal (i.p.) and intravenous (i.v.) ways in a mouse ...199910865897
oral itraconazole therapy for superficial, subcutaneous, and systemic infections. a panoramic view.the availability of the oral triazole agents itraconazole and fluconazole has revolutionized antifungal therapy. although there are still some limitations and treatment failures, these agents have allowed for improved efficacy, increased safety, reduced morbidity, decreased mortality from systemic fungal disease, and a shift toward increased outpatient therapy for fungal infections that are not life-threatening. the treatment of superficial infections also has been enhanced by the development of ...199910492666
antifungal activity of the new azole uk-109, 496 (voriconazole).the in vitro activity of voriconazole fully includes aspergillus, and also emerging moulds like fusarium, pseudallescheria boydii, and penicillium marneffei. the minimal inhibitory concentrations of voriconazole for candida krusei and candida glabrata, which are resistant or less susceptible to fluconazole, promise clinical efficacy, although they are ten times higher (0.30-0.39 microgram/ml) than those for candida albicans and other candida spp. (0.001-0.05 microgram/ml). the endemic fungal pat ...199910865910
blastomyces dermatitidis occurring as an isolated cerebellar mass.although abundant in nature, fungi are infrequently pathogenic in humans. cns fungal infections in non-immunocompromised individuals are uncommon. we discuss here the case of an otherwise healthy black woman with an isolated mass of the cerebellopontine angle identified as blastomyces dermatitidis, successfully treated with surgical resection of the mass and intravenous amphotericin b therapy.199910547020
fatal visceral and neural sarcocystosis in dogs.this paper describes acute visceral and neural sarcocystosis in four dogs. one animal was simultaneously infected with distemper virus, and another with blastomyces dermatitidis. schizonts and merozoites of sarcocystis canis were found in the lesions. 1999 w.b. saunders and company ltd.199910405310
the effect of canine macrophages on the adherence and growth of blastomyces dermatitidis yeast: evidence of a soluble factor that enhances the growth of b. dermatitidis yeast.blastomycosis is a medically important systemic fungal infection of dogs and humans. phagocytic cells are the first line of cellular defence against b. dermatitidis, and are a prominent feature in the lesions and exudate of canine blastomycosis. the adherence of b. dermatitidis yeast to canine phagocytes, and the effects of such adherence on the growth of b. dermatitidis yeast, has not been previously reported. the results of this study demonstrate that canine complement enhances the adherence o ...199910588912
the in vitro isolation of blastomyces dermatitidis from a woodpile in north central wisconsin, usa.environmental isolations of the dimorphic fungus, blastomyces dermatitidis, the aetiologic agent of blastomycosis are rare, and have usually involved animal inoculation techniques. we report the in vitro isolation of b. dermatitidis from a woodpile in november 1997, from a private property in a highly endemic area of north central wisconsin, usa. the woodpile was 73 m from the wisconsin river and 5 m from a kennel which had housed nine dogs over the past 14 years, four of which had been diagnose ...199910421847
murine models of blastomycosis, coccidioidomycosis, and histoplasmosis.animal models have contributed much to the knowledge of fungal infections and their corresponding therapeutic treatments. this is true for animal models of the primary fungal pathogens, blastomyces dermatitidis, coccidioides immitis, and histoplasma capsulatum. this review gives a brief background of human diseases associated with these organisms and describes the development, details, and utility of murine models of blastomycosis, as well as coccidioidomycosis and histoplasmosis.199910822504
endemic mycoses: a treatment update.endemic mycoses remain a major public health problem in several countries and they are becoming increasingly frequent with the spread of hiv infection. amphotericin b remains the drug of choice during the acute stage of life-threatening endemic mycoses occurring in both immunocompetent and immunocompromised hosts. ketoconazole is effective in non-aids patients with non-life-threatening histoplasmosis, blastomycosis, or paracoccidioidomycosis. itraconazole is the treatment of choice for non-life- ...199910223586
thoracic and abdominal blastomycosis in a horse.a 5-year-old quarter horse mare was examined because of lethargy, fever, and weight loss of 1 month's duration. thoracic auscultation revealed decreased lung sounds cranioventrally. thoracic ultrasonography revealed bilateral anechoic areas with hyperechoic strands, consistent with pleural effusion and fibrin tags. a large amount of free fluid was evident during abdominal ultrasonography. abnormalities included anemia, hyperproteinemia, hyperglobulinemia, hyperfibrinogenemia, and hypoalbuminemia ...199910319179
thoracic blastomycosis and empyema.blastomycosis is endemic in river valley areas of the southeastern and midwestern united states. pulmonary manifestations include chronic cough and pleuritic pain. radiographic appearance of the infection can mimic bronchogenic lung carcinoma. pleural effusion is rarely associated with this pulmonary infection, and empyema has not been previously reported. we report a case of pulmonary and pleural blastomyces dermatitidis infection presenting as empyema thoracis. diagnosis and treatment were att ...199910323175
"giant" blastoconidia of candida albicans: morphologic presentation and concepts regarding their production.candida albicans normally produces blastoconidia measuring 2 to 8 microns in diameter. markedly enlarged "giant" (approximately 30 microns) blastoconidia of a c. albicans isolate (designated bh) were observed after growth on commercially prepared chocolate agar already supplemented with isovitalex (bbl-microbiology systems, cockeysville, md, usa). morphologically, "giant" blastoconidia presented a spectrum of forms such as blastoconidia with linear creases, with a single broad-based bud resembli ...199910342104
endemic fungal pneumonia in immunocompromised patients.the endemic fungi histoplasma capsulatum, coccidioides immitis, and blastomyces dermatitidis tend to reside in specific geographic regions. the organisms are pathogenic in that they are able to produce clinical disease in both immunocompromised patients and in patients with normal immunity. these organisms have a variety of clinical presentations, some of which typically are seen in the normal host and others that are primarily encountered in persons with abnormal immunity. although most of the ...19999894949
unilateral blastomyces dermatitidis endophthalmitis and orbital cellulitis. a case report and literature review.the authors report the clinical, cytologic, and histopathologic findings of a unique presentation of concomitant unilateral endophthalmitis and orbital cellulitis secondary to blastomyces dermatitidis.19989709759
immunogenicity and protective efficacy of the wi-1 adhesin of blastomyces dermatitidis.people infected with blastomyces dermatitidis develop strong immunity to the yeast surface adhesin wi-1, including antibody responses to the adhesive domain, a 25-amino-acid repeat, and cellular responses to the n terminus. we studied the immunogenicity of wi-1 and the ability of anti-wi-1 immune responses to protect against lethal pulmonary infection in mice. wi-1 immunization, given in freund's adjuvant subcutaneously in two doses 2 weeks apart, evoked delayed hypersensitivity responses in a c ...19989784555
misleading manifestations of coccidioides immitis in vivo.we describe a case of coccidioidomycosis in which several unusual morphologic forms of coccidioides immitis occurred in biopsy tissue from the right lower lung of a patient. to our knowledge, this is the first case where so many diverse morphologic forms were manifested in a single patient in the absence of typical endosporulating spherules. immature spherules demonstrating segmentation mimicked morula forms of prototheca spp. certain elements resembled budding cells of blastomyces dermatitidis. ...19989817907
intergenic transcribed spacer pcr ribotyping for differentiation of saccharomyces species and interspecific hybrids.the taxonomy of the genus saccharomyces has undergone significant changes recently with the use of genotypic rather than phenotypic methods for the identification of strains to the species level. the sequence of rrna genes has been utilized for the identification of a variety of fungi to the species level. this methodology, applied to species of saccharomyces, allows unknown saccharomyces isolates to be assigned to the type strains. it was the aim of the present study to assess whether typing of ...19989542932
susceptibilities of clinical and laboratory isolates of blastomyces dermatitidis to ketoconazole, itraconazole, and fluconazole.eighteen isolates of blastomyces dermatitidis were evaluated for their in vitro susceptibilities to ketoconazole, itraconazole, and fluconazole. the mic ranges were 0.1 to 0.4 microg/ml for ketoconazole, < or =0.018 to 0.07 microg/ml for itraconazole, and 2.5 to 4.0 microg/ml for fluconazole. the ranges for the minimal lethal concentrations were 0.2 to 0.8 microg/ml for ketoconazole, < or =0.018 to 0.07 microg/ml for itraconazole, and 10 to 40 microg/ml for fluconazole. itraconazole was the most ...19989559827
fine needle aspiration cytology of primary isolated splenic blastomyces dermatitidis. a case report.blastomyces dermatitidis is a dimorphic fungus; its usual port of entry is the lung. although any organ system can be secondarily involved, non-pulmonary sites of primary infection have been reported.19989568144
virulence factors in fungi of systemic mycoses.pathogenic fungi that cause systemic mycoses retain several factors which allow their growth in adverse conditions provided by the host, leading to the establishment of the parasitic relationship and contributing to disease development. these factors are known as virulence factors which favor the infection process and the pathogenesis of the mycoses. the present study evaluates the virulence factors of pathogenic fungi such as blastomyces dermatitidis, coccidioides immitis, cryptococcus neoforma ...19989830725
blastomycosis as an etiology of acute lung injury.blastomyces dermatitidis, a dimorphic broad-based budding yeast endemic to the mississippi river valley region, is responsible for morbidity in humans via inhalation and dissemination. the response of acute lung injury, which produces an illness with serious morbidity and an approximately 50% mortality, uncommonly occurs. diagnosis can be difficult, and a high index of suspicion should be maintained in endemic regions for patients with acute lung injury of uncertain etiology, especially if their ...19989743060
simultaneous infection with blastomyces dermatitidis and cryptococcus neoformans.in this report, we present two cases of simultaneous infection with blastomyces dermatitidis and cryptococcus neoformans. in both cases, fungi were isolated from the lungs. the clinical manifestations were not suggestive of infection with two fungi. one patient was receiving immunosuppressive therapy and another was otherwise immunocompetent. a review of the literature failed to uncover any reports of co-infection with these two fungal pathogens. we discuss possible mechanisms for the isolation ...19989776812
neck mass resulting from local extension of pulmonary blastomycosis.blastomycosis is an endemic systemic fungal infection that usually involves the lungs and superficial skin. although head and neck involvement has been reported in the literature, no previous cases of neck mass resulting from direct extension of a pulmonary lesion have been published. we encountered an immunocompetent 31-year-old woman with a rapidly enlarging subcutaneous neck mass and a chronic upper lung infiltrate. imaging studies showed contiguity between both lesions. blastomyces dermatiti ...19989786290
in vitro activity of the new triazole voriconazole (uk-109,496) against opportunistic filamentous and dimorphic fungi and common and emerging yeast pathogens.the in vitro antifungal activity of a new triazole derivative, voriconazole, was compared with those of itraconazole and amphotericin b against 67 isolates of aspergillus flavus, aspergillus fumigatus, bipolaris spp., fusarium oxysporum, fusarium solani, pseudallescheria boydii, rhizopus arrhizus, blastomyces dermatitidis, histoplasma capsulatum, and sporothrix schenckii. the in vitro activities of voriconazole were also compared with those of amphotericin b, fluconazole, and itraconazole agains ...19989431946
molecular genetic variation in emmonsia crescens and emmonsia parva, etiologic agents of adiaspiromycosis, and their phylogenetic relationship to blastomyces dermatitidis (ajellomyces dermatitidis) and other systemic fungal pathogens.emmonsia crescens, an agent of adiaspiromycosis, blastomyces dermatitidis, the agent of blastomycosis, and histoplasma capsulatum, the agent of histoplasmosis, are known to form meiotic (sexual) stages in the ascomycete genus ajellomyces (onygenaceae, onygenales), but no sexual stage is known for e. parva, the type species of the genus emmonsia. to evaluate relationships among members of the putative ajellomyces clade, large-subunit ribosomal and internal transcribed spacer region dna sequences ...19989738044
flow cytometric quantitation of yeast a novel technique for use in animal model work and in vitro immunologic assays.animal models of fungal and other infectious diseases often require that the number of organisms in tissue be quantified, traditionally by grinding organs, plating them on agar and counting colony forming units (cfu). this method is labor intensive, slow as some fungi require two weeks of culture and limited in reliability by poor plating efficiency. to circumvent these problems, we developed a flow cytometric method to quantify yeast. in vitro cultured blastomyces dermatitidis, cryptococcus neo ...19989617831
comparison of in vitro activities of the new triazole sch56592 and the echinocandins mk-0991 (l-743,872) and ly303366 against opportunistic filamentous and dimorphic fungi and yeasts.the in vitro antifungal activities of sch56592, mk-0991, and ly303366 against 83 isolates of acremonium strictum, aspergillus flavus, aspergillus fumigatus, aspergillus terreus, bipolaris spp., blastomyces dermatitidis, cladophialophora bantiana, fusarium oxysporum, fusarium solani, histoplasma capsulatum, phialophora spp., pseudallescheria boydii, rhizopus arrhizus, scedosporium prolificans, and sporothrix schenckii were compared. the in vitro activities of these agents against 104 isolates of ...19989738049
clinical, cytologic and histopathologic manifestations of protothecosis in two dogs.two cases of sudden onset of blindness associated with ocular protothecosis in dogs are reported. both were adult, spayed female, mixed-breed dogs that lacked the usual clinical signs of systemic infection with prototheca species. physical abnormalities at the time of presentation were limited to the affected eyes which had serous discharge, hyperemic conjunctiva, and aqueous flare. the pupillary light reflexes were slow, and the menace reflexes were absent. both dogs had glaucoma. results of co ...199811397236
fdg accumulation in disseminated blastomyces dermatitidis in a dog. 199814516584
[etiology of the first african case of systemic blastomycosis].several authors have suggested that african and north american forms of blastomyces dermatitidis appeared separate taxa. morphologic and pathogenic differences not only prevail, but also the failing to mate between them. african forms lose their mycelium-yeast conversion capability in old cultures. so i propose to create the complementary appellation blastomyces dermatitidis tunisiens nov.subsp. from the african forms, in memory of the first case of systemic blastomycosis in this continent, disc ...199814666745
cross-reactivity in histoplasma capsulatum variety capsulatum antigen assays of urine samples from patients with endemic mycoses.we evaluated cross-reactivity in the antigen assay used for the diagnosis of histoplasmosis by testing urine samples from patients with disseminated fungal infections. the mycoses chosen for this study were selected on the basis of the observation that during clinical testing, cross-reactions may occur between histoplasma capsulatum var. capsulatum, paracoccidioides brasiliensis, blastomyces dermatitidis, coccidioides immitis, and penicillium marneffei. we detected antigen in 12 of 19 patients w ...19979195077
molecular taxonomy and epidemiology of blastomyces and histoplasma species.cladistic analysis of partial 26s rrna sequences was used to estimate evolutionary distances among species and varieties of the dimorphic onygenalean genera blastomyces, coccidioides, emmonsia, histoplasma and paracoccidioides. with the exception of coccidioides, all genera were closely related, with about 5% base differences and even less (1-2%) between blastomyces and emmonsia. these data were supported by a teleomorph in the same genus ajellomyces. in a phylogenic study of a wide range of asc ...19979375491
immunological and chemical characterization of glycoproteins in ief fractions of blastomyces dermatitidis yeast lysate antigen.after isoelectric focusing (ief), fractions of a blastomyces dermatitidis yeast lysate antigen were analysed for the presence of glycoproteins that may lead to cross-reactivity in immunoassays for the diagnosis of blastomycosis. five major glycoproteins were apparent, two of which showed cross-reactivity when used in western blots with sera obtained from dogs with histoplasmosis and coccidioidomycosis. these five glycoproteins were characterized for linkage to the proteins using n-glycosidase f ...19979375492
identification of blastomyces dermatitidis in the stool of a dog with acute pulmonary blastomycosis.we report the identification of blastomyces dermatitidis by microscopic examination of a direct faecal smear from a dog with pulmonary blastomycosis. a simultaneously obtained faecal culture grew blastomyces dermatitidis. the fungus was also cultured from a transtracheal sample from this same dog. this report suggests that yeast-phase cells of b. dermatitidis may be recovered in the stool of dogs with pulmonary blastomycosis following transit through the gastrointestinal tract of swallowed infec ...19979467109
comparative studies on the detection of antibodies and delayed hypersensitivity responses with 10 blastomyces dermatitidis lysate antigens.yeast-phase lysate antigens were prepared from 10 different isolates of blastomyces dermatitidis. comparative studies were performed using the lysate antigens in an enzyme-linked immunosorbent assay (elisa) for the detection of antibodies in sera from dogs with blastomycosis and histoplasmosis. in order to evaluate the ability of the lysate reagents to elicit delayed dermal hypersensitivity (dth) responses, the lysates were compared as skin-testing antigens in hairless guinea pigs that were prev ...19979476480
activation, binding, and processing of complement component 3 (c3) by blastomyces dermatitidis.complement plays a key role in phagocyte recognition and killing of blastomyces dermatitidis, but little is known about how complement components interact with the yeast. we report the characteristics of activation, binding, and processing of c3 by b. dermatitidis. in pooled normal human serum (nhs), deposition of c3 on the yeast was detectable within 2 min, whereas in nhs containing mgegta, deposition was delayed by 6 min, indicating that the yeast activates c3 by both classical and alternative ...19979125571
pulmonary blastomycosis with acute respiratory failure as predominant clinical feature.two previously healthy young adults came to our community hospital with rapidly progressive respiratory failure. investigation confirmed blastomyces as the responsible etiologic agent. despite adequate antifungal chemotherapy and intensive supportive care, both patients died, one within 24 hours and the other after 14 days. overwhelming infection with blastomyces dermatitidis can cause acute respiratory failure, possibly the adult respiratory distress syndrome, even in immunocompetent hosts.19979258317
purification in quantity of the secreted form of wi-1: a major adhesin on blastomyces dermatitidis yeasts.wi-1, a 120-kda adhesin on blastomyces dermatitidis, binds the yeast to macrophages and is a major target antigen of immune recognition in acquired resistance to the fungus. in past studies, wi-1 has been purified by extracting the protein from the yeast cell wall, which yields microgram quantities for biological assays. we report a strategy for generating and purifying the secreted form of wi-1 in quantity. yeasts of b. dermatitidis atcc strain 60636 cultured in hmm medium were found to secrete ...19979367819
cutaneous blastomycosis. report of a case with diagnosis by fine needle aspiration cytology.blastomycosis is rare in india. clinically, cutaneous blastomycosis may be mistaken for keratoacanthoma, squamous cell carcinoma, tuberculosis, tertiary syphilis, leprosy or pyoderma.19979990265
mapping of a coccidioides immitis-specific epitope that reacts with complement-fixing antibody.we have previously cloned the cdna fragment that encodes the complement fixation antigen of coccidioides immitis. the recombinant protein was highly sensitive in detecting cf antibody in sera from patients with coccidioidomycosis but was not specific to c. immitis, as evidenced by its reactivity with sera from patients with histoplasmosis and, to lesser extent, blastomycosis. we undertook this study to determine if the epitope(s) that reacts with cf antibody is the same or differs from the epito ...19979317009
in vitro antifungal activity of bms-181184 against systemic isolates of candida, cryptococcus, and blastomyces species.bms-181184 is a water-soluble derivative of the pradimicin group of antifungal compounds. we determined the in vitro activities of bms-181184 and comparator agents amphotericin b, 5-fluorocytosine, fluconazole, and ketoconazole against 184 systemic fungal isolates collected at the health sciences centre in winnipeg, canada, between 1987 and 1995. bms-181184 demonstrated mics of between 1 and 8 micrograms/ml for all candida albicans, candida glabrata, candida tropicalis, candida krusei, candida l ...19979327245
detection of antibodies and delayed dermal hypersensitivity with different lots of blastomyces dermatitidis yeast lysate antigen: stability and specificity evaluations.comparative evaluations were performed to assess the stability, sensitivity and specificity of eight lots of yeast lysate antigen prepared from a blastomyces dermatitidis dog isolate (t-58). these antigens were prepared during the period from 1989 to 1995. the lysates were used in an elisa for the detection of antibodies in serum specimens from dogs with blastomycosis and histoplasmosis. in order to evaluate the ability of the lysates to elicit delayed dermal hypersensitivity (dth) responses, th ...19979476514
efficacy of nikkomycin z against experimental pulmonary blastomycosis.nikkomycin z is a chitin synthetase inhibitor. in vitro, nikkomycin z had good activity against blastomyces dermatitidis, with an mic of 0.78 microg/ml and a minimal fungicidal concentration of 3.1 microg/ml. the efficacies of various treatment durations (3, 5, or 10 days) and doses (200, 400, or 1,000 mg/kg of body weight) of nikkomycin z given twice daily were compared with those of itraconazole at 200 mg/kg given twice daily and amphotericin b at 6.25 mg/kg in a murine model of pulmonary blas ...19979303408
role of cell surface molecules of blastomyces dermatitidis in the pathogenesis and immunobiology of blastomycosis.the cell surface of pathogenic microbes is critical in directing their interactions with the host. the discovery of a 120 kd antigen/adhesin wi-1 on the yeast or parasitic form of blastomyces dermatitidis has elucidated the molecular basis of host/pathogen interactions in blastomycosis. wi-1 has three structural domains: (1) an n-terminal hydrophobic domain that spans the cell membrane, (2) a c-terminal epidermal growth factor-like domain that may bind extracellular matrix, and (3) a central dom ...19979313291
recombinant coccidioides immitis complement-fixing antigen: detection of an epitope shared by c. immitis, histoplasma capsulatum, and blastomyces dermatitidis.we undertook an investigation to assess the utility of a recombinant coccidioides immitis complement-fixing (cf) antigen for detecting cf antibody in sera from patients with coccidioidomycosis. enzyme-linked immunosorbent assays established that recombinant cf antigen and, for comparison, a commercially available coccidioidin were reactive with 19 of 19 sera from patients with active coccidioidomycosis. the recombinant antigen was significantly more sensitive than coccidioidin. the median titer ...19979008276
transforming dna integrates at multiple sites in the dimorphic fungal pathogen blastomyces dermatitidis.blastomyces dermatitidis is a primary fungal pathogen of man and other mammals, but like many other human fungal pathogens, relatively little is known about the factors that account for its virulence and pathogenicity. we developed a transformation system to facilitate molecular genetic studies of putative virulence factors from b. dermatitidis. transformation of the multinucleate yeasts was achieved by electroporation of dnas containing a dominant selectable marker, hygromycin b (hygb) resistan ...19979074500
diagnosis of blastomycosis.during the 100 years since blastomyces dermatitidis was discovered as a cause of human disease, diagnostic tests, methods of collection of specimens, and laboratory techniques have improved significantly. radiographic advances and the introduction of the fiberoptic bronchoscopy have allowed for more reliable clinical diagnoses. more sensitive serologic techniques and dna probes have significantly improved the sensitivity of laboratory diagnosis. at present, the most reliable serologic tests are ...19979313297
virulent isolates and mutants of blastomyces in mice: a legacy for studies of pathogenesis.this article provides information on the history of blastomyces dermatitidis isolates and spontaneous mutants, the relationship with maintenance of cultures, and their virulence as quantified in murine models. virulent isolates have been obtained from soil or from patients. regardless of origin, mutants attenuated in virulence have sometimes arisen from storage as frozen yeast, frozen mycelia, or refrigerated yeast or serial passage in vitro at 35 degrees to 37 degrees c. once virulence is lost, ...19979313289
in vitro activity of a new semisynthetic echinocandin, ly-303366, against systemic isolates of candida species, cryptococcus neoformans, blastomyces dermatitidis, and aspergillus species.the in vitro activities of ly-303366, a new semisynthetic echinocandin, and comparators amphotericin b, 5-fluorocytosine, fluconazole, and ketoconazole against 205 systemic isolates of candida species, cryptococcus neoformans, blastomyces dermatitidis, and aspergillus species were determined. ly-303366 had mics of < or = 0.32 microg/ml for all candida albicans (n = 99), candida glabrata (n = 18), and candida tropicalis (n = 10) isolates tested. ly-303366 was also active against aspergillus speci ...19979087508
african strains of blastomyces dermatitidis that do not express surface adhesin wi-1.african strains of blastomyces dermatitidis differ from north american strains in their growth, morphology, and clinical disease phenotype. in addition, two serotypes, designated 1 and 2, have been described. we investigated african strains of b. dermatitidis for expression of the surface protein adhesin wi-1 and found that serotype 2 strains do not express it because they lack the coding sequence in their genome. the defect will make the strains useful for gene complementation and for testing t ...19979119493
in vitro and in vivo activities of sch 56592 against blastomyces dermatitidis.the new triazole derivative sch 56592 has been tested in a national committee for clinical laboratory standards-adapted in vitro susceptibility test, and its activity against 12 isolates of blastomyces dermatitidis yeast-like forms has been compared with those of amphotericin b, itraconazole, and fluconazole. sch 56592 was the most active of the four compounds, with an mic at which 90% of the isolates are inhibited of 0.06 microgram/ml and a minimal fungicidal concentration at which 90% of the i ...19968723494
induction and detection of cell-mediated reactions with different blastomyces dermatitidis antigenic preparations.blastomyces dermatitidis yeast-phase antigens (killed cell, kwy; lysate, lys; and filtrate, fil) from canine isolate t-58 were compared with respect to the induction and detection of cellular immune responses in mice. the antigens exhibited good sensitivity and specificity when used to detect a delayed-type hypersensitivity (dth) response in mice previously immunized with t-58 or histoplasma capsulatum antigens. greater reactivity was observed with the kwy and lys antigens as dth-inducing agents ...19968766999
human pathogeneic fungi and their close nonpathogenic relatives.in order to understand the relationships between human pathogenic fungi and their close, nonpathogenic relatives, we compared small-subunit ribosomal dna sequences among four closely related pathogens, histoplasma capsulatum, blastomyces dermatitidis, trichophyton rubrum, and coccidioides immitis, and seven nonpathogenic fungi expected on morphological grounds to be their nearest relatives. we sequenced small-subunit rna genes from these fungi and used both genetic distance and parsimony algorit ...19968812309
fungal infections: a growing threat.the emergence of newly identified fungal pathogens and the reemergence of previously uncommon fungal diseases is primarily related to increases in the numbers of susceptible persons: people with hiv infection, bone marrow and organ transplant recipients, cancer patients being treated with chemotherapy, critically ill persons, and very low birth weight ( < or = 1500 g) infants. these immunocompromised populations are at risk for infection not only with opportunistic pathogens (for example, pneumo ...19968643813
community-acquired fungal pneumonia in children.pediatric fungal pulmonary infections are being seen with increasing frequency. the dimorphic fungi histoplasma capsulatum. blastomyces dermatitidis, coccidioides immitis, and cryptococcus neoformans frequently cause infections that are asymptomatic. however, patients may suffer pneumonia and disseminated disease. diagnosis can be made definitively by isolation of the causative organism, but serology or skin testing is often necessary when this is not successful. severe or life threatening infec ...19968883177
ajellomyces crescens sp. nov., taxonomy of emmonsia spp., and relatedness with blastomyces dermatitidis (teleomorph ajellomyces dermatitidis).adiaspiromycosis is known primarily as a pulmonary infection of small burrowing mammals and rarely of humans, in which the tissue spore form consists of a large, globose, thick-walled, non-proliferating structure called an adiaspore. the causative agents have been placed in emmonsia or chrysosporium and treated as either two species or varieties. emmonsia parva (= chrysosporium parvum var. parvum) has been distinguished from e. crescens (= c parvum var. crescens) by differences in maximum growth ...19968912163
chronic localized osteomyelitis caused by atypical infection with blastomyces dermatitidis in a dog.a 4-year-old male golden retriever was evaluated because of chronic non-weight-bearing lameness of the right hind limb associated with penetrating tarsal wounds. arthritis of the tarsal joint and osteomyelitis of the talus were initially evident. tarsal arthrodesis was performed 7 months after initial injury, but the lameness persisted. ten months later, blastomycosis was diagnosed on the basis of results of histologic examination of bone biopsy specimens and serologic tests. no other site of in ...19968944801
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