Cephalotheca foveolata
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Cephalotheca foveolata | |
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Species: | Cephalotheca foveolata
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Binomial name | |
Cephalotheca foveata Yaguchi, Nishimura & Udagawa (2006)
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History and taxonomy
Cephalotheca foveolata was first discovered in 2006 in a subcutaneous infection of the foot in South Korea.[1][2] The fungus was said to be “foveolate” because of it’s small pitted ascospores.[2] The fungus has also been called Cephalotheca faveolata by Giridharan, Verekar, Khanna, Mishra, Deshmukh in 2012. [3] C. foveolata is morphologically and molecularly very similar to other pathogenic species of fungus, especially those within the genera of Phialemonium and Acremonium.[4] The D1/D2 variable domains of 28S rDNA have often been used to identify C. foveolata. [4][1] This is necessary to distinguish C. foveolata from Cephalotheca sulfurea which has 95% homology or Phialemonium obovatum, another closely related species. [5][2]
Habitat and ecology
C. foveolata has been discovered rarely but in different areas around the world that are very separate from each other. [6] Most cases have been reported in the southern United States or southeast Asia (Korea, Singapore, and Hong Kong). [5][7] As a saprophyte, C. foveolata generally makes its home in the soil, but can also be found growing on wood or mushrooms. [4][1] An exact niche for this fungus has yet to be detailed. [4]
Growth and morphology
C. foveolata displays both teleomorph and anamorph stages in vitro as well as in its natural habitat, it is one of very few Ascomycetes that is able to do so. [4][6]. It also produces thick walled chlamydospores with a 3-6µm diameter.[2]
In vitro the C. foveolata is black, brown, white, orange even yellowish sometimes.[2] The colonies reach a 45-50mm diameter in vitro on OA or PDA media in 14 days at 25°C. [2] It’s maximum growth temperature is 39°C though 25°C is optimal.[2] When grown on PFA medium C. foveolata produces a reddish brown diffusing pigment.[4]
Conidiogenesis occurs in vitro.[2] These conidiogenous cells remain undifferentiated from hyphae and are monophialidic with ellipsoidal conidia at the end of short conidiophores.[2][1] The conidia are translucent, cylindrical, 4-5x1.5-2µm, and are said to be very similar to the conidia of Phialemonium.[2] The cleistothecia fruiting bodies are dark and ciliated with a peridium made of elongated, thick walled cells.[2][6]
The pitted ascospores for which C. foveolata gets its name are generally kidney shaped, 4-5x3-4x2.5-3µm, and hyaline to brown. [6][2] The sexual spores are found in translucent brown 8 celled asci.[2]
Mechanism of pathology
C. foveolata has been described as an opportunistic human pathogen and it is potentially consumed as a contaminant on food. [4] After the first reported case in South Korea there have been 6 other cases as of 2011. [4] Cases have included subcutaneous infections, infections of eyes, nails, lymph nodes, cardiac tissue, bronchial fluid, and one case of bloodstream infection. [4][7] Symptoms were minor for all cases except in the case of the bloodstream infection. where the patient had fevers, upper back pain and shortness of breath.[4] Patients with subcutaneous infections had chronic granulomatous inflammation around infection; otherwise, urinalysis, liver/renal function tests, stool examinations, blood counts and smears all return results within normal limits.[1]
Treatment
When C. foveolata was first discovere in South Korea a surgical removal was performed. The patient was followed for a year afterwards and it seemed the surgery was successful. [1] Since then many anti-fungal drugs have been tried against C. foveolata. The most effective drugs so far have been amphotericin B, itraconazole, posaconazole and voriconazole. They inhibit all growth after 48 hours at 35°C.[4] Caspofungin causes abnormal growth after 24 hours and is not considered effective.[4] C. foveolata seems to be resistant to AMB, itraconazole, and terbinafine.[1][5]
Physiology
Cephalotheca foveolata produces a metabolite called sclerotiorin. Sclerotiorin has been shown to induce apoptosis in colon cancer cells by activating a pathway leading to caspase-3 activation. [3]
Lu 2015
- symptoms of human infection: fevers, upper back pain and shortness of breath (bloodstream infection)[4]
- found in the soil and on other environmental matter[4]
- teleomorph (sexual) and anamorph (asexual) stages in vitro and in natural habitat. The anamorph morphology akin to Phialemonium and Acremonium[4]
- 7 case as of 2011 ( in eyes, lymph nodes, cardiac tissue and bronchial lavage fluid)[4]
- 1st reported case of bloodstream infection in 2011[4]
- potentially an opportunistic human pathogen[4]
- produce a brown to reddish diffusing pigment (on PFA)[4]
- amphotericin B, itraconazole, posaconazole and voriconazole inhibit all growth at lowest concentration after 48 hours at 35°C[4]
- Caspofungin causes abnormal growth at the lowest concentration after 24 hours[4]
- potentially found on human skin or in foods as a contaminant[4]
- since morphology is similar to other pathogenic species DNA analysis of the 28S rDNA is required for identification[4]
- environmental niche currently unknown[4]
Pedromo 2011
- molecularly and morphologically related to P. obovatum[5]
- reported in Singapore, Texas, South Carolina, Ohio, North Carolina[5]
- reported in Endocarditis, lymph node, bronchial fluid, eyes[5]
- resistant to AMB[5]
Suh 2006
- first case of sub cutaneous Cephalotheca foveolata in 2006 (erythematous plaques with clear boundary)[8]
- surgical removal worked (followed for a year afterwards)[8]
- Saprophytic, found in soil, wood and mushrooms.[8]
- full blood count, peripheral blood smear, urinalysis, liver and renal function tests, and stool examination were within normal limits (aka, subcutaneous infection won’t impact those organs)[8]
- chronic granulomatous inflammation around infection[8]
- ellipsoidal conidia at the end of short conidiophores [8]
- itraconazole for the first 3 months and then with terbinafine for another 9 months led to no change[8]
- D1/D2 variable domains of 28S rDNA must be analysed to differentiate from similar pathogenic species[8]
Sutton 2008
- one of few Ascomycetes that is homothallic and makes teleomorph structures in vitro[6]
- Cephalotheca foveolate is rare[6]
Yaguchi 2006
- first isolated/defined in 2006 (in Korea), subcutaneous infection of foot[2]
- Phialemonium-like conidia (also similar to the hyphomycete Teberdinia)[2]
- ascomycota have yellow straight or wavy hairs[2]
- pitted, kidney shaped ascospores (4-5x3-4x2.5-3µm), translucent/yellowish[2]
- 95% homology to Cephalotheca sulfurea[2]
- max growth temp 39°C[2]
- 25°C growth faster than 35°C growth[2]
- colonies reach 45-50mm diameter in vitro (OA media or PDA media) in 14 days at 25°C[2]
- conidiogenesis does occur in vitro[2]
- in vitro: black, brown, white, orange even yellowish sometimes[2]
- Cleistothecia fruiting bodies[2]
- peridium is made of elongated, thick walled cells[2]
- translucent/brownish, 8 celled asci[2]
- conidiogenous cells undifferentiated from hyphae but at the terminal end (monophhialidic), cylindrical, 10-20x2-3µm[2]
- Conidia are translucent, cylindrical, and 4-5x1.5-2µm[2]
- 3-6µm thick walled chlamydospores[2]
Tsang 2017
- Cephalotheca foveolata is appearing in Hong Kong recently[7]
References
- ^ a b c d e f g Cite error: The named reference
Suh2005
was invoked but never defined (see the help page). - ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac Yaguchi T, Sano A, Yarita K, Suh M, Nishimura K, Udagawa S (2006). "A new species of Cephalotheca isolated from a Korean patient". Mycotaxon. 96: 30–322.
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(help)CS1 maint: extra punctuation (link) - ^ a b Giridharan P, Verekar SA, Khanna A, Mishra PD, Deshmukh SK (2012). "Anticancer activity of sclerotiorin, isolated from an endophytic fungus Cephalotheca faveolata Yaguchi, Nishim. & Udagawa". Indian Journal of Experimental Biology. 50 (7): 464–468. PMID 22822525.
- ^ a b c d e f g h i j k l m n o p q r s t u v w x Lu L, Weil A, Wiederhold N, Sutton D, Chesnut L, Lindner J, Fan H, Tingpej B, El-Khoury J, Kwon D (2015). "Probable case of Cephalotheca foveolata bloodstream infection". JMM case reports. 2 (4): 1–5. doi:10.1099/jmmcr.0.000045.
- ^ a b c d e f g Perdomo H, Sutton D, García D, Fothergill A, Gene J, Cano J, Summerbell R, Rinaldi M, Guarro J (2011). "Molecular and Phenotypic Characterization of Phialemonium and Lecythophora Isolates from Clinical Samples". Journal of Clinical Microbiology. 49 (4): 1209–1216. doi:10.1128/JCM.01979-10.
- ^ a b c d e f Sutton D, MT, SM(ASCP), RM, SM(NRM) (2008). "Rare and Emerging Agents of Hyalohyphomycosis". Current Fungal Infection Reports. 2 (3): 134–142. doi:10.1007/s12281-008-0020-4.
- ^ a b c Tsang C (2017). "Diversity of novel and emerging pathogenic fungi in Hong Kong". The University of Hong Kong.
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(help)CS1 maint: extra punctuation (link) - ^ a b c d e f g h Suh M, Lim J, Lee Y, Ha G, Kim H, Kim J, Yaguchi T, Nishimura K (2006). "Subcutaneous hyalohyphomycosis due to Cephalotheca foveolata in an immunocompetent host". British Journal of Dermatology. 154 (6): 1184–1189. doi:10.1111/j.1365-2133.2006.07158.x.