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Emmonsiosis

From Wikipedia, the free encyclopedia
Fungal infection
Medical condition
Emmonsiosis
Other namesEmergomycosis[1]
SpecialtyInfectious diseases[2]
SymptomsSkin rash[2]
CausesEmergomyces, previously classified under genusEmmonsia[3]
Risk factorsHIV,organ transplant,steroid use.[1]
Diagnostic methodskin biopsy,histopathology[1]
Differential diagnosisHistoplasmosis[1]
TreatmentAntifungals
MedicationAmphotericin B[1]
FrequencyRare[1]

Emmonsiosis, also known asemergomycosis, is a systemicfungal infection that can affect thelungs, generally always affects theskin and can become widespread.[1][2] The lesions in the skin look like small redbumps and patches with adip,ulcer anddead tissue in the centre.[4]

It is caused by theEmergomyces species, a novel dimorphicfungus, previously classified under the genusEmmonsia.[3] These fungi are found in soil and transmitted bybreathing in its spores from the air.[1] Inside the body it converts to yeast-like cells which then cause disease and invade beyond the lungs.[1] Diagnosis is byskin biopsy and itsappearance under the microscope.[5] It is difficult to distinguish fromhistoplasmosis.[3][6]Treatment is usually withamphotericin B.[3]

Emmonsiosis can be fatal.[3] The disseminated type is more prevalent in South Africa, particularly in people withHIV.[3]

Signs and symptoms

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Generally, all cases have involvement of the skin.[5] The lesions look like small redbumps and patches with adip,ulcer anddead tissue in the centre.[4] There may be several lesions and their distribution can be widespread.[1] The lungs may be affected.[3][4]

Cause

[edit]

It is caused by theEmergomyces species, a novel dimorphic fungus, previously classified under the genusEmmonsia.[3][7] Following arevised taxonomy in 2017 based onDNA sequence analyses, five of theseEmmonsia-like fungi have been placed under the separate genusEmergomyces.[3] These includeEmergomyces pasteurianus,Emergomyces africanus,Emergomyces canadensis,Emergomyces orientalis andEmergomyces europaeus.[3][8]

Emergomyces africanus was previously known asEmmonsia africanus, which has similarfeatures toHistoplasma spp. and the family ofAjellomycetaceae.[6]

The disease has been observed among people who have aweakened immune system and risk factors includeHIV,organ transplant andsteroid use.[1][3]

Mechanism

[edit]

The fungus is found in soil and is released in the air.[1] Transmission is bybreathing in fungal spores from the air.[1] Inside the body it converts to yeast-like cells which then cause disease and invade beyond the lungs.[1] In people with HIV, Emmonsiosis has been associated withImmune reconstitution inflammatory syndrome following initiatingantiretroviral treatment.[1]

Diagnosis

[edit]

Diagnosis is byskin biopsy and itsappearance under the microscope.[5]

Differential diagnosis

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Generally, it is difficult to distinguish from histoplasmosis.[6] Other conditions that appear similar includetuberculosis,[5]blastomycosis,sporotrichosis,chicken pox,Kaposi's sarcoma anddrug reactions.[4]

Treatment

[edit]

Treatment usually includesamphotericin B.[3]

Prognosis

[edit]

It can be fatal.[5]

Epidemiology

[edit]

The disseminated type is more prevalent in South Africa, particularly in people with HIV.[5]

History

[edit]

The disease was thought to be a rare condition of the lung.[2] Early cases may have been misdiagnosed as histoplasmosis.[6]

Other animals

[edit]

The genusEmmonsia can cause adiaspiromycosis, a lung disease in wild animals.[9]

References

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  1. ^abcdefghijklmnoSchwartz, Ilan S.; Govender, Nelesh P.; Sigler, Lynne; Jiang, Yanping; Maphanga, Tsidiso G.; Toplis, Barbra; Botha, Alfred; Dukik, Karolina; Hoving, J. Claire; Muñoz, Jose F.; Hoog, Sybren de; Cuomo, Christina A.; Colebunders, Robert; Kenyon, Chris (19 September 2019)."Emergomyces: The global rise of new dimorphic fungal pathogens".PLOS Pathogens.15 (9) e1007977.doi:10.1371/journal.ppat.1007977.ISSN 1553-7374.PMC 6752945.PMID 31536607.
  2. ^abcd"ICD-11 - ICD-11 for Mortality and Morbidity Statistics".icd.who.int. Retrieved28 May 2021.
  3. ^abcdefghijklSamaddar, Arghadip; Sharma, Anuradha (2021)."Emergomycosis, an Emerging Systemic Mycosis in Immunocompromised Patients: Current Trends and Future Prospects".Frontiers in Medicine.8 670731.doi:10.3389/fmed.2021.670731.ISSN 2296-858X.PMC 8104006.PMID 33968970.
  4. ^abcdKutzner, Heinz; Kempf, Werner; Feit, Josef; Sangueza, Omar (2021)."2. Fungal infections".Atlas of Clinical Dermatopathology: Infectious and Parasitic Dermatoses. Hoboken: Wiley Blackwell. p. 102.ISBN 978-1-119-64706-5.
  5. ^abcdefSchwartz, Ilan S.; Govender, Nelesh P.; Corcoran, Craig; Dlamini, Sipho; Prozesky, Hans; Burton, Rosie; Mendelson, Marc; Taljaard, Jantjie; Lehloenya, Rannakoe; Calligaro, Greg; Colebunders, Robert; Kenyon, Chris (15 September 2015)."Clinical Characteristics, Diagnosis, Management, and Outcomes of Disseminated Emmonsiosis: A Retrospective Case Series".Clinical Infectious Diseases.61 (6):1004–1012.doi:10.1093/cid/civ439.ISSN 1537-6591.PMID 26060283.
  6. ^abcdCalonje, J. Eduardo; Grayson, Wayne (2020)."18. Infectious diseases of the skin". In Calonje, J. Eduardo; Brenn, Thomas; Lazar, Alexander J.; Billings, Steven D. (eds.).McKee's Pathology of the Skin, 2 Volume Set (5th ed.). Elsevier. pp. 959–960.ISBN 978-0-7020-6983-3.
  7. ^Govender, Nelesh P.; Grayson, Wayne (2019)."Emergomycosis (Emergomyces africanus) in Advanced HIV Disease".Dermatopathology.6 (2):63–69.doi:10.1159/000495405.ISSN 2296-3529.PMC 6827448.PMID 31700845.
  8. ^Jiang, Yanping; Dukik, Karolina; Muñoz, Jose F.; Sigler, Lynne; Schwartz, Ilan S.; Govender, Nelesh P.; Kenyon, Chris; Feng, Peiying; van den Ende, Bert Gerrits; Stielow, J. Benjamin; Stchigel, Alberto M.; Lu, Hongguang; de Hoog, Sybren (1 May 2018)."Phylogeny, ecology and taxonomy of systemic pathogens and their relatives in Ajellomycetaceae (Onygenales): Blastomyces, Emergomyces, Emmonsia, Emmonsiellopsis".Fungal Diversity.90 (1):245–291.doi:10.1007/s13225-018-0403-y.hdl:10067/1520590151162165141.ISSN 1878-9129.S2CID 46987097.
  9. ^Henry, RonnieEtymologia: Emmonsia.Emerging Infectious Diseases. 2017;23(2):348. doi:10.3201/eid2302.et2302.
Superficial and
cutaneous
(dermatomycosis):
Tinea =skin;
Piedra (exothrix/
endothrix) =hair
Ascomycota
Dermatophyte
(Dermatophytosis)
By location
By organism
Other
Basidiomycota
Subcutaneous,
systemic,
andopportunistic
Ascomycota
Dimorphic
(yeast+mold)
Onygenales
Other
Yeast-like
Mold-like
Basidiomycota
Zygomycota
(Zygomycosis)
Mucorales
(Mucormycosis)
Entomophthorales
(Entomophthoramycosis)
Microsporidia
(Microsporidiosis)
Mesomycetozoea
Ungrouped
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