REGISTER
LOG IN
HOME
RESOURCES
Publications
Conference Calendar
Past Quiz Results
ARTICLES
First-ever Study of Mycology Lab Practices in Asia
Fereydounia khargensis: A New Opportunistic Yeast Reported from Malaysia
9 Years of MMTN: Improving Fungal Disease Management in Asia Pacific
Echinocandins: Clinicians' Guide
Fungemia blood culture media
Deep dermatophytosis
AFWG Education Module 4: Is Antifungal Susceptibility Testing Useful for Clinical Management?
AFWG Education Module 5: TDM of Antifungal Agents - Essential or Optional?
AFWG Education Module 6: Antifungal Stewardship
Itraconazole: A Quick Guide for Clinicians
Evolving Fungal Landscape in Asia
Laboratory Diagnosis of Pythiosis
ICMR Issues C. auris Advisory
Strengths and Limitations of Imaging for Diagnosis of IFI
Candidemia: Lessons Learned from Asian Studies for Intervention
Pivotal Asian Invasive Mold Study
Mycetoma in Asia: Still veiled in mystery
Cryptococcosis
New Antifungal Agents
Making Precise Diagnoses: Experience from the Laboratory Skills Enhancement Course
AFWG Online Education Module 3: Optimizing Dosing in IFI Management
AFWG Online Education Module 2: Antifungal Prophylaxis in Solid Organ Transplantation
AFWG Education Module 1: The Value of Clinical Mycology Laboratories
Cryptococcosis in HIV and non-HIV infected patients
Human Pythiosis
AFWGOnline Privacy Policy has been Updated
Recent Advances of Fungal Diagnostics in Asian Laboratories
Deep Dermatophytosis: A Case Report
Emerging yeast infections in Asia
Championing Medical Mycology: Thoughts on the AFWG Laboratory Skills Enhancement Course
Mucormycosis and Pythiosis – New Insights
AML and the high risk of multiple infectious complications
Do We Need Modification of Recent IDSA & ECIL Guidelines while Managing Patients in Asia?
A hospital’s experience with candidemia and empirical therapy
Fungal Academy 2015
Fluconazole in 2015
Fungal isolation protocol
Influencing Aspergillus
Fungal Asthma
Aspergillus
Laboratory Diagnosis of IPA
Two-Hot-to-Handle
Voriconazole
Educational Organizations
Literature Updates
 

Articles

Mucormycosis And Pythiosis – New Insights

Share this
page



Share
this page

Dr Ariya Chindamporn
Associate Professor
Department of Microbiology
Faculty of Medicine
Chulalongkorn University
Bangkok, Thailand

The revised taxonomy classifies fungi causing mucormycosis in the new subphylum Mucoromycotina.1 This subphylum and the subphylum entomophthoromycotina were formerly among the 2 orders that were members of the zygomycota division.1 The 2 subphyla are pathogens similar in size and both have aseptate hyphae; however, they differ in their infected host, clinical manifestation and spore types.1 Rhizopus species is the most common mucormycosis-causing agent.2

Studies performed in mucormycosis patients worldwide revealed that the underlying conditions differ between patients in developed countries and those in developing countries. The European continent sees higher cases of underlying hematological malignancies in mucormycosis patients3 in contrast with countries such as India4 and Mexico,5 which report diabetes as the predominant underlying condition in their patients.

Pathogenesis of mucormycosis: Role of CotH receptor agents

The regulatory protein CotH on the surface of the mucorales fungi specifically bind to the glucose receptor protein GRP78 on the surface of the host endothelial cells. This interaction facilitates fungal invasion of the cell, subsequently causing damage to the endothelial cells, promoting angioinvasion and dissemination.6 Investigations show that interruption of CotH in Rhizopus oryzae is able to disrupt the invasive potential of the pathogen, making CotH a promising therapeutic target.6

Pythiosis: A fungus-like organism

An increasing trend in cases of human pythiosis has been observed in the past 10 years, with Thailand reported to have the highest number of cases worldwide.7 Clinical manifestations of human pythiosis can be classified into 4 types: cutaneous/subcutaneous; ocular; vascular; and disseminated pythiosis. In vascular pythiosis, 4 classic clinical presentations that should be of concern are underlying thalassemia, no atherosclerotic risk, history of previous leg wound and presentation with acute or chronic limb ischemia.8 The ocular form, on the other hand, is commonly linked to a history of eye contact with water, such as through contact lens wear and swimming pool use. Rapid and definite diagnosis and treatment are crucial to patients’ survival and preservation of the eye globe.

References

  1. Kwon-Chung KJ. Clin Infect Dis 2012;54:Suppl 1:S8-S15.
  2. Roden MM, et al. Clin Infect Dis 2005;41:634-653.
  3. Skiada A, et al. Clin Microbiol Infect 2011;17:1859-1867.
  4. Chakrabarti A, et al. Med Mycol 2006;44:335-342.
  5. Corzo-Leon DE, et al. Med Mycol 2017 [Epub ahead of print].
  6. Gebremariam T, et al. J Clin Invest 2014;124:237-250.
  7. Krajaejun T, et al. Clin Infect Dis 2006;43:569-576.
  8. Reanpang T, et al. Int J Low Extrem Wounds 2015;14:245-250.
SIGN UP FOR NEWSLETTER
SIGN UP

This field is required. Please enter your email address.
Thank you for signing up for the AFWG newsletter.
You have previously subscribed for AFWG newsletter.