Abstract
Chaetomium species have been rarely described as aetiological agents of invasive and dermatomycotic infections in humans. The majority of cases have been reported within the last two decades. Treatment failed in most of these cases. In this paper we present two cases in which Chaetomium spp. can be clearly identified as an aetiological agent in pathological conditions. In the first report, we describe a new aetiological agent, Chaetomium brasiliense, which was implicated in a case of otitis externa in a patient with spinocellular carcinoma basis cranii. The patient had been repeatedly treated for relapsing otitis externa and had previously undergone surgery several times for otitis media. The fungal aetiology was confirmed by repeated positive culture and histologic studies. The second case involved onychomycosis with strikingly brown nail discoloration due to Chaetomium globosum in an otherwise healthy patient. The nail lesion was successfully cured by oral terbinafine. The determination of both species was supported by sequencing of rDNA regions. The morphological aspect of Chaetomium spp. identification is also discussed. In vitro antifungal susceptibility tests demonstrated that both isolates were susceptible to terbinafine and azole derivates except fluconazole. Amphotericin B was effective only against the C. brasiliense strain. We review the literature to summarize clinical presentations, histologic findings, and treatment strategies.
Ackowledgments
The project was made possible thanks to grant MSM 6007665801. We would like to thank Dr Miroslav Kolarik, Dr Ondrej Koukol, Dr Dagmar Jechova and Dr Alena Kubatova for their support, for reading of the manuscript and their helpful and positive feedback.
Declaration of interest: The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the paper.
Note
*The EMBL accession numbers for the ITS region and LSU rDNA of Chaetomium brasiliense and C. globosum are FR718872-3 and FR823008-9.
This paper was first published online on Early Online on 8 April 2011.