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Human Pathogenic Entomophthorales.

Raquel Vilela1,2, Leonel Mendoza3,4

  • 1Biomedical Laboratory Diagnostics, Michigan State University, East Lansing, Michigan, USA.

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|August 31, 2018
PubMed
Summary
This summary is machine-generated.

Entomophthoralean fungi infect insects and mammals, causing diseases like rhinofacial infections. Diagnosis and treatment are challenging due to fungal resistance and limited research, necessitating further investigation into host immunology.

Keywords:
BasidiobolusConidiobolusEntomophthoralesEntomophthoramycotabasidiobolomycosisconidiobolomycosisentomophthoramycosisrhinoconidiobolomycosisrhinoentomophthoramycosis

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Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Tropical Medicine

Background:

  • Entomophthoralean fungi, including Basidiobolus and Conidiobolus species, are pathogenic agents found in tropical and subtropical environments.
  • These fungi infect both insect and mammalian hosts, with transmission occurring via insect bites or contact with contaminated environments.
  • Conidiobolus coronatus typically causes rhinofacial disease in immunocompetent individuals, while other species can affect immunocompromised patients.

Purpose of the Study:

  • To review the clinical manifestations, diagnosis, and management of infections caused by entomophthoralean fungi.
  • To highlight the diagnostic challenges, particularly in differentiating Basidiobolus ranarum infections from other intestinal diseases.
  • To underscore the need for further research into the immunology and treatment of these infections.

Main Methods:

  • Review of existing literature on entomophthoralean fungal infections.
  • Analysis of clinical presentations, diagnostic laboratory methods (wet mount, culture, serology, molecular assays), and histopathological findings (eosinophilic granulomas, Splendore-Höeppli phenomenon).
  • Evaluation of current therapeutic strategies, including antifungal agents (potassium iodide, amphotericin B, itraconazole, ketoconazole) and surgical interventions.

Main Results:

  • Infections present with diverse clinical manifestations, ranging from chronic rhinofacial disease to subcutaneous, intestinal, and disseminated infections.
  • Diagnosis can be difficult, especially in immunocompromised patients where typical inflammatory responses may be absent.
  • Entomophthoralean fungi exhibit intrinsic resistance to certain antifungals, often requiring combination therapies and surgical management.

Conclusions:

  • Early diagnosis of entomophthoralean fungal infections remains a significant challenge.
  • Effective management requires a combination of antifungal therapy and surgical intervention due to inherent drug resistance.
  • Further research, including the development of animal models and increased funding, is crucial to advance our understanding of entomophthoralean fungi immunology and treatment.