A dimorphic fungus causing disseminated infection in South Africa

Chris Kenyon1, Kim Bonorchis, Craig Corcoran

  • 1Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa. chriskenyon0@gmail.com

Abstract

Insights

A new Emmonsia species, closely related to E. pasteuriana, caused disseminated fungal infections in HIV-infected adults in South Africa. This dimorphic fungus represents a significant emerging pathogen in Cape Town.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Molecular Phylogenetics

Background:

  • The genus Emmonsia includes species known to cause human adiaspiromycosis.
  • Limited information exists regarding Emmonsia species pathogenic to humans.
  • A novel Emmonsia species was identified in HIV-infected adults in South Africa.

Purpose of the Study:

  • To identify the causative agent of systemic, dimorphic fungal infections in HIV-infected patients.
  • To characterize a novel Emmonsia species based on clinical and molecular data.

Main Methods:

  • Enhanced surveillance for systemic fungal infections.
  • DNA sequencing for fungal identification.
  • Phylogenetic analysis of five genes (LSU, ITS1-2, actin, β-tubulin, intein PRP8).

Main Results:

  • Thirteen cases of Emmonsia infection were diagnosed in HIV-infected patients with disseminated disease.
  • Patients had low CD4+ T-cell counts (median 16 cells/mm³).
  • Phylogenetic analysis confirmed the fungus belongs to the genus Emmonsia and is closely related to E. pasteuriana.

Conclusions:

  • The identified Emmonsia isolates represent a new species pathogenic to humans.
  • This new species is an important cause of fungal infections in Cape Town.
  • Prompt diagnosis and treatment with antifungal and antiretroviral therapy are crucial.

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