HistoryThis section has been translated automatically.
Emmons and Ashburn, 1942
DefinitionThis section has been translated automatically.
Systemic mycosis of the lungs, which occurs worldwide in lower vertebrates (rodents) and is only very rarely infectious for humans.
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PathogenThis section has been translated automatically.
Emmonsia spp., in particular Emmonsia crescens and Emmonsia parva. "Adiaspiromykosis" is derived from the conidia of the pathogens (adiaconidia), which have the rare ability to grow extensively without replication at body temperatures but never to multiply in the host. Enlargement from 1-2 μm to 200-600 μm (E. crescens) or 20-40 μm (E. parva) and expansion of volume to up to 1 million times the extracorporeal state after uptake into the host's lungs.
EtiopathogenesisThis section has been translated automatically.
Infection with Emmonsia spp. by uptake of spores from the soil or dust via the respiratory tract.
ManifestationThis section has been translated automatically.
Mostly in patients with severe immunosuppression, e.g. HIV-infected persons.
Clinical featuresThis section has been translated automatically.
- Very rarely disseminated courses outside the lung infestation with cough, slight fever, sputum and shortness of breath.
- Skin infestation: Preferably on the extremities and face single or multiple, ulcerating, granulomatous papules with a verrucous-crustose surface as well as larger nodules which tend to ulceration and reach into the subcutis.
DiagnosisThis section has been translated automatically.
Clinic, X-ray thorax (reticulonodular infiltrates), bronchoalveolar lavage, lung biopsy, cultivation of the pathogen in culture from biopsy specimen (typical: adiaspores!)
Internal therapyThis section has been translated automatically.
Amphotericin B (e.g. Amphotericin B) i.v. 1 mg/kg bw/day for 4-6 weeks or liposomal Amphotericin B (e.g. AmBisome) initial 1 mg/kg bw i.v.; if necessary, gradually increase to 3 mg/kg bw i.v. Alternatively: Fluconazole (e.g. Diflucan) 200-400 mg/day i.v. until the infection subsides.
Progression/forecastThis section has been translated automatically.
Occasionally spontaneous healing with a good immune constitution; with immunosuppression often a fulminant course.
LiteratureThis section has been translated automatically.
- Echavarria E et al (1993) Disseminated adiaspiromycosis in a patient with AIDS. J Med Vet Mycol 31: 91-97
- Emmons CW, Ashburn LL (1942) The isolation of Haplosporangium parvum n.sp. and Coccidiodiodes immitis from wild rodents. Public Health Rep 57: 1715-1727
- Peres LC et al (1992) Fulminant disseminated pulmonary adiaspiromycosis in humans. Am J Trop Med Hyg 46: 146-150
- Peterson SW ET AL: (1998) Molecular genetic variation in Emmonsia crescens and Emmonsia parva, etiologic agents of adiaspiromycosis, and their phylogenetic relationship to Blastomyces dermatitidis (Ajellomyces dermatitidis) and other systemic fungal pathogens. J Clin Microbiol 36: 2918-2925
- Turner D et al (1999) Pulmonary adiaspiromycosis in a patient with acquired immunodeficiency syndrome. Eur J Clin Microbiol Infect Dis 18: 893-895
Incoming links (1)Lung diseases, skin changes;
Outgoing links (1)Hiv infection;
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