Breast abscess due to Nannizziopsis obscura in an immunocompromised renal transplant patient after travel to Nigeria : case report and review
© 2023. The Author(s)..
BACKGROUND: Nannizziopsis is a genus of fungi with several known cases in reptiles of pyogranulomatous infections at cutaneous and musculoskeletal level, of rapid and fatal evolution. There are few cases of this genus described in humans, mainly skin affection but also with visceral abcesses, typically in immunosuppressed patients, with a recent visit to Africa.
CASE PRESENTATION: A 45-year-old woman immunosuppressed after renal transplantation and with a recent visit to Nigeria presented with a painless breast abcess, ulceration to the skin and bleeding, and non hematic telorrhea. The mammogram, also completed with an ultrasound scan, showed a polylobulated nodule, BI-RADS 4C. Due to the suspicion of breast cancer, a core needle biopsy was performed and the pathology study showed abundant presence of fungal spores and hyphae. It was identified by genomic amplification of the internal transcription spacer region-2 and a percentage of similarity with sequences of Nannizziopsis obscura from GenBank of 98% was obtained. An empiric treatment with anidulafungin was initiated, and after the surgical resection, it was replaced by isavuconazole, with a total time of treatment of one month.
CONCLUSIONS: This is the first case report of a successful treatment of Nannizziopsis obscura with isavuconazole, with the shortest time of treatment published for this fungi. We highlighted the importance of referring difficult to diagnose species to reference centers, as well as achieving the most complete resection in order to shorten the antibiotic therapy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:23 |
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| Enthalten in: |
BMC infectious diseases - 23(2023), 1 vom: 24. Jan., Seite 50 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jiménez-García, Nicolás [VerfasserIn] |
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| Links: |
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| Themen: |
60UTO373KE |
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| Anmerkungen: |
Date Completed 26.01.2023 Date Revised 01.02.2023 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1186/s12879-022-07958-3 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM352047054 |
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| 100 | 1 | |a Jiménez-García, Nicolás |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Breast abscess due to Nannizziopsis obscura in an immunocompromised renal transplant patient after travel to Nigeria |b case report and review |
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| 500 | |a Date Revised 01.02.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a BACKGROUND: Nannizziopsis is a genus of fungi with several known cases in reptiles of pyogranulomatous infections at cutaneous and musculoskeletal level, of rapid and fatal evolution. There are few cases of this genus described in humans, mainly skin affection but also with visceral abcesses, typically in immunosuppressed patients, with a recent visit to Africa | ||
| 520 | |a CASE PRESENTATION: A 45-year-old woman immunosuppressed after renal transplantation and with a recent visit to Nigeria presented with a painless breast abcess, ulceration to the skin and bleeding, and non hematic telorrhea. The mammogram, also completed with an ultrasound scan, showed a polylobulated nodule, BI-RADS 4C. Due to the suspicion of breast cancer, a core needle biopsy was performed and the pathology study showed abundant presence of fungal spores and hyphae. It was identified by genomic amplification of the internal transcription spacer region-2 and a percentage of similarity with sequences of Nannizziopsis obscura from GenBank of 98% was obtained. An empiric treatment with anidulafungin was initiated, and after the surgical resection, it was replaced by isavuconazole, with a total time of treatment of one month | ||
| 520 | |a CONCLUSIONS: This is the first case report of a successful treatment of Nannizziopsis obscura with isavuconazole, with the shortest time of treatment published for this fungi. We highlighted the importance of referring difficult to diagnose species to reference centers, as well as achieving the most complete resection in order to shorten the antibiotic therapy | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a Immunocompromised | |
| 650 | 4 | |a Nannizzia obscura | |
| 650 | 4 | |a Nannizziopsis obscura | |
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| 700 | 1 | |a Guillén Rodríguez, Celeste María |e verfasserin |4 aut | |
| 700 | 1 | |a Castilla Castellano, María Del Mar |e verfasserin |4 aut | |
| 700 | 1 | |a Del Arco Jiménez, Alfonso |e verfasserin |4 aut | |
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