Clinical Significance of Pseudallescheria boydii: A Review of 10 Years' Experience
Section snippets
MATERIAL AND METHODS
All specimens submitted for culture were inoculated onto inhibitory mold agar; brain-heart infusion agar that contained 10% sheep blood, 5 μg/ml of gentamicin, and 16 μg/ml of chloramphenicol; brain-heart infusion agar that contained 10% sheep blood, 5 μg/ml of gentamicin, 16 μg/ml of chloramphenicol, and 500 μg/ml of cycloheximide; and Sabouraud's 2% dextrose agar. Cultures were incubated at 30°C for 30 days. Previously reported methods were used to identify isolates of P. boydii on the basis
CULTURE RESULTS
The time from submission of the 83 cultures to identification of P. boydii ranged from 2 to 30 days (median, 10 days). Of these specimens, 36 (43%) were from the respiratory tract, 25 (30%) from soft tissue, 9 (11%) from bone, and 13 (16%) from other sites (Table 1). Of the 36 cultures (from 32 patients) from the respiratory tract, 34 (94%) represented colonization and 2 (6%) were clinically significant (Table 2). Of the 30 patients with colonization, 26 (87%) had underlying pulmonary disease
REPORT OF CASES
The 10 cases of clinically significant P. boydii infection are summarized in Table 2. Additional detailed information is provided for six of these cases.
DISCUSSION
Only 10 previous reports have described substantiated P. boydii infection of the central nervous system.6, 30, 31, 32, 33, 39, 42, 51, 52, 53 In one of these cases, meningitis had resulted from contamination of the cerebrospinal fluid during spinal anesthesia.51 Granulomatous meningitis occurred in a second, presumably healthy, patient.52 The third case of P. boydii infection was associated with pansinusitis in a woman with diabetes.53 Brain abscesses were diagnosed in the remaining seven
ACKNOWLEDGMENT
We thank Roberta M. Kondert for secretarial assistance.
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Mayo Graduate School of Medicine, Rochester, Minnesota