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Human pythiosis associated with thalassemia hemoglobinopathy syndrome

B Sathapatayavongs1, P Leelachaikul, R Prachaktam

  • 1Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand.

The Journal of Infectious Diseases
|February 1, 1989
PubMed

Insights

Pythium infection, or pythiosis, is newly described in humans as a cause of fungal arteritis. This condition, particularly in farmers with thalassemia, can lead to severe arterial issues and death.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Pythium species are known causes of disease in animals but human infections were previously undescribed.
  • Areas endemic for animal pythiosis lack documented human cases.
  • Fungal arteritis is a rare but serious vascular infection.

Observation:

  • Five human patients presented with a unique form of fungal arteritis affecting medium- to large-sized arteries.
  • Clinical manifestations included limb gangrene, aneurysm formation, and fatal arterial leakage.
  • All affected patients were farmers and most had thalassemia hemoglobinopathy syndrome.

Findings:

  • Fungal isolation from patients was challenging.
  • Standard antifungal treatment with Amphotericin B appeared ineffective.
  • Pythium infection should be suspected in patients with unexplained arterial occlusion, especially those with thalassemia.

Implications:

  • This study highlights a novel human pathogen and disease presentation.
  • Early diagnosis and aggressive treatment, including surgical debridement and potassium iodide, are crucial.
  • Increased awareness is needed in tropical regions for Pythium arteritis in at-risk populations.

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