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Invasive Infections with Nannizziopsis obscura Species Complex in 9 Patients from West Africa, France, 2004-2020

by Garcia-Hermoso, Dea , Galeazzi, Guy , Gits-Muselli, Maud , Brun, Sophie , Berre, Rozenn Le , Bretagne, Stephane , Fekkar, Arnaud , Siguier, Martin , Denis, Blandine , Vidal, Valerie , Jabet, Arnaud , Hamane, Samia , Haddad, Elie , Nevez, Gilles , Lanternier, Fanny

in Abscesses / Antibiotics / Antifungal agents / Antigens / Biopsy / emergence and immunosuppression / Fungi / Health aspects / Hospitalization / Identification / Immunotherapy / Infections / invasive fungal infections / Invasive Infections with / Magnetic resonance imaging / Medical imaging / Metronidazole / Nannizziopsis / Onygenales / Posaconazole / Reptiles / Skin / Species Complex in 9 Patients from West Africa, France, 2004–2020 / T cells / Tomography / Transplants & implants / West Africa

2020

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Invasive Infections with Nannizziopsis obscura Species Complex in 9 Patients from West Africa, France, 2004-2020

2020

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Invasive Infections with Nannizziopsis obscura Species Complex in 9 Patients from West Africa, France, 2004-2020

2020

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Journal Article

Invasive Infections with Nannizziopsis obscura Species Complex in 9 Patients from West Africa, France, 2004-2020

Garcia-Hermoso, Dea,

Galeazzi, Guy,

Gits-Muselli, Maud,

Brun, Sophie,

Berre, Rozenn Le,

Bretagne, Stephane,

Fekkar, Arnaud,

Siguier, Martin,

Denis, Blandine,

Vidal, Valerie,

Jabet, Arnaud,

Hamane, Samia,

Haddad, Elie,

Nevez, Gilles,

Lanternier, Fanny

2020

Overview

Nine new human invasive infections caused by the keratinophilic fungi Nannizziopsis obscura have been reported in France since 2004. The patients had variable clinical manifestations, had frequent dissemination, were mainly T-cell immunocompromised, and all originated from sub-Saharan West Africa. Before collection of the isolates, the etiologies of these infections were often misidentified, underscoring the extent of microscopic and cultural polymorphisms. All isolates but 1 had low MICs for the 8 antifungal drugs tested. When treated, patients received mainly azole therapy. Two of 7 patients with a known outcome died. We performed multilocus sequence analysis of N. obscura clinical strains and several strains of Nannizziopsis spp. isolated from reptiles. The human strains were clearly differentiated from the animal strains. N. obscura might be endemic to West Africa and responsible for undetected infections, which might become reactivated when immunosuppression occurs. N. obscura infection is probably underestimated because only sequencing enables proper identification.

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Publisher

U.S. National Center for Infectious Diseases,Centers for Disease Control and Prevention

Subject

/ Biopsy

/ emergence and immunosuppression

/ Fungi