Morphological and Molecular Characterization of Exophiala polymorpha sp. nov. Isolated from Sporotrichoid Lymphocutaneous Lesions in a Patient with Myasthenia Gravis

J Clin Microbiol. 2015 Sep;53(9):2816-22. doi: 10.1128/JCM.00622-15. Epub 2015 Jun 17.

Abstract

Exophiala species are capable of causing cutaneous and subcutaneous infections in immunocompromised patients. An Exophiala isolate was cultured from a biopsy specimen of a lesion on the forearm of a patient with myasthenia gravis. The patient also had lesions on the palm and distal aspects of the hand, which were successfully treated with a long-term course of itraconazole. A detailed morphological and molecular characterization of the isolate was undertaken. Phylogenetic analysis of the internal transcribed spacer region and portions of the β-tubulin and translation elongation factor 1-alpha genes indicated that the isolate was a novel species closely related to but genetically distinct from species within the Exophiala spinifera clade; the name Exophiala polymorpha sp. nov. is proposed. Morphologically, E. polymorpha most closely resembles E. xenobiotica but it differs in possessing phialides bearing prominent, wide collarettes, and it does not produce chlamydospores.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antifungal Agents / therapeutic use
  • Biopsy
  • Cluster Analysis
  • DNA, Fungal / chemistry
  • DNA, Fungal / genetics
  • DNA, Ribosomal Spacer / chemistry
  • DNA, Ribosomal Spacer / genetics
  • Dermatomycoses / diagnosis*
  • Dermatomycoses / drug therapy
  • Dermatomycoses / microbiology
  • Dermatomycoses / pathology*
  • Exophiala / classification*
  • Exophiala / cytology
  • Exophiala / genetics
  • Exophiala / isolation & purification*
  • Female
  • Histocytochemistry
  • Humans
  • Itraconazole / therapeutic use
  • Microbiological Techniques
  • Microscopy
  • Molecular Sequence Data
  • Myasthenia Gravis / complications*
  • Peptide Elongation Factor 1 / genetics
  • Phaeohyphomycosis / diagnosis*
  • Phaeohyphomycosis / drug therapy
  • Phaeohyphomycosis / microbiology
  • Phaeohyphomycosis / pathology*
  • Phylogeny
  • Sequence Analysis, DNA
  • Treatment Outcome
  • Tubulin / genetics

Substances

  • Antifungal Agents
  • DNA, Fungal
  • DNA, Ribosomal Spacer
  • Peptide Elongation Factor 1
  • Tubulin
  • Itraconazole

Associated data

  • GENBANK/KP070763
  • GENBANK/LN794350
  • GENBANK/LN794351