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adiaspiromycosis
ICD-10 Codes
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Description
What is Adiaspiromycosis?
Adiaspiromycosis is a rare pulmonary disease caused by the inhalation of spores of the saprophytic soil fungus Chrysosporium parvum var. crescens (Emmonsia crescens) [1]. This fungus is found in soil and can be cosmopolitan in distribution, meaning it can be found on every continent.
Causes and Transmission
The disease occurs when humans inhale spores of the fungus, which are present in the environment. The exact mechanism of transmission is not well understood, but it is believed that the fungus grows within the lung tissue, forming large, thick-walled resting cells called adiaspores [3].
Symptoms and Diagnosis
Adiaspiromycosis can manifest as a fungal infection in the lungs or skin. Symptoms may include respiratory distress, which can be severe enough to require mechanical ventilation [2]. The disease is typically diagnosed through transbronchial biopsy, which reveals the presence of adiaspores within granulomata.
Treatment and Prognosis
Treatment for adiaspiromycosis usually involves antifungal medications such as amphotericin products and corticosteroids, followed by itraconazole [2]. In some cases, patients may make a full recovery. However, the disease is rare and more research is needed to understand its replication and dissemination within the body.
Susceptible Populations
Members of the Family Mustelidae (which includes weasels, otters, and minks) seem to be highly susceptible to adiaspiromycosis [15]. The exact reason for this susceptibility is not clear.
Additional Characteristics
- A rare pulmonary disease caused by inhaling spores of the saprophytic soil fungus Chrysosporium parvum var. crescens (Emmonsia crescens)
- Symptoms include respiratory distress, which can be severe enough to require mechanical ventilation
- Treatment involves antifungal medications and corticosteroids
- Members of the Family Mustelidae (weasels, otters, minks) are highly susceptible
Signs and Symptoms
Signs and Symptoms of Adiaspiromycosis
Adiaspiromycosis, a rare fungal infection caused by the inhalation of spores of the saprophytic soil fungus Chrysosporium parvum var crescens, can manifest in various ways. Here are some of the common signs and symptoms associated with this condition:
- Skin involvement: All cases of adiaspiromycosis have skin lesions, which appear as small red bumps and patches with a dip, ulcer, or dead tissue [7].
- Ocular-related signs and symptoms:
- Conjunctival hyperemia (89%): Redness and inflammation of the conjunctiva [8][9]
- Conjunctival nodule (70%): A bump or lump on the conjunctiva [8]
- Excessive tearing (63%): Increased tear production, often accompanied by redness and irritation [8]
- Conjunctival pruritus (60%): Itching or burning sensation in the eyes [8]
- Respiratory symptoms: In some cases, adiaspiromycosis can cause respiratory problems, such as cough, fever, weight loss, fatigue, and dyspnea [1].
- Other symptoms: Some patients may experience a "warm feeling" around the skin lesion [5].
It's essential to note that many human cases of adiaspiromycosis are self-limited or asymptomatic, but in severe cases, it can lead to respiratory failure and even death [3]. If you suspect you have adiaspiromycosis or any other fungal infection, consult a healthcare professional for proper diagnosis and treatment.
References: [1] GM Anstead (2012) - Cited by 85 [3] GM Anstead (2012) - Cited by 85 [5] WG Stebbins (2004) - Cited by 22 [7] - context result 7 [8] - context result 8 [9] - context result 9
Additional Symptoms
- Skin involvement
- * Skin lesions appear as small red bumps and patches with a dip, ulcer, or dead tissue
- **Ocular-related signs and symptoms**:
- + Conjunctival hyperemia (89%): Redness and inflammation of the conjunctiva
- + Conjunctival nodule (70%): A bump or lump on the conjunctiva
- + Excessive tearing (63%): Increased tear production, often accompanied by redness and irritation
- + Conjunctival pruritus (60%): Itching or burning sensation in the eyes
- **Respiratory symptoms**: In some cases, adiaspiromycosis can cause respiratory problems, such as cough, fever, weight loss, fatigue, and dyspnea
- skin lesion
Diagnostic Tests
Diagnostic Tests for Adiaspiromycosis
Adiaspiromycosis, a rare fungal infection, can be challenging to diagnose. However, several diagnostic tests are available to confirm the presence of this condition.
- Histological Studies: The identification of the fungus in a pulmonary specimen through histological studies is crucial for diagnosing adiaspiromycosis [1]. This involves examining tissue samples under a microscope to visualize the fungus.
- Transbronchial Biopsy and Tracheal Aspiration: A transbronchial biopsy and tracheal aspiration can be performed to confirm the diagnosis of adiaspiromycosis due to Emmonsia [2].
- Visualization of Adiaspores: The visualization of adiaspores in pulmonary biopsy specimens is a reliable method for diagnosing pulmonary adiaspiromycosis [3].
- Molecular Biology: Molecular biology techniques, such as PCR and sequencing, can be used to optimize diagnostic tests and improve patient care [4]. This was demonstrated in a case study where molecular biology was used to diagnose adiaspiromycosis for the first time.
- Immunologic Diagnostic Methods: Immunologic diagnostic methods, including antibody and antigen detection, are also used to diagnose adiaspiromycosis. However, their evidence is presumptive diagnosis [5].
- Microscopic Pathologic Examination: The microscopic pathologic examination of transbronchial lung biopsy can be non-diagnostic in some cases [6].
These diagnostic tests are essential for confirming the presence of adiaspiromycosis and guiding treatment decisions.
References: [1] Context 1 [2] Context 2 [3] Context 3 [4] Context 4 [5] Context 8 [6] Context 9
Additional Diagnostic Tests
- Transbronchial Biopsy and Tracheal Aspiration
- Visualization of Adiaspores
- Molecular Biology
- Immunologic Diagnostic Methods
- Microscopic Pathologic Examination
- Histological Studies
Treatment
Treatment Options for Adiaspiromycosis
Adiaspiromycosis, a fungal infection caused by Emmonsia crescens, can be treated with various antifungal medications and supportive care.
- Antifungal Medications: The recommended regimen consists of amphotericin B (deoxycholate or liposomal formulation) for 1–2 weeks, followed by oral itraconazole for at least 6 months [7]. Other antifungal drugs such as fluconazole and ketoconazole have also been used to treat adiaspiromycosis [4].
- Corticosteroids: Corticosteroids may be used in conjunction with antifungal medications to reduce inflammation and manage symptoms [1, 5].
- Supportive Care: Supportive care, including rest, hydration, and nutrition, is often necessary to help the body recover from adiaspiromycosis [6].
Treatment Outcomes
The effectiveness of treatment for adiaspiromycosis varies depending on the severity of the infection and the individual's immune response. In severe cases, antifungal medications may be necessary to prevent complications and promote recovery.
- Mild Cases: Mild cases of adiaspiromycosis often resolve on their own without treatment [6].
- Severe Cases: Severe cases require prompt medical attention and treatment with antifungal medications and supportive care [2, 3].
References
[1] RM Silva (2010) - Treatment with corticosteroids without antifungal drugs was chosen, and the patient responded well to this, with improvements in clinical and radiological findings.
[2] GM Anstead (2012) - In severe pulmonary adiaspiromycosis in the immunocompetent host, it is reasonable to give both antifungal treatment to destroy the organism that provokes the disease.
[3] JM Dot (2009) - After confirmation of the diagnosis of adiaspiromycosis, an antifungal treatment with oral itraconazole (200 mg/day) was started on 10 June 2008.
[4] GM Anstead (2012) - Anecdotally, clinical improvement in patients with adiaspiromycosis has been reported using a number of drugs, including ketoconazole.
[5] GM Anstead (2012) - The patient received amphotericin products and corticosteroids, followed by itraconazole, and made
Recommended Medications
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Differential Diagnosis
Understanding Differential Diagnosis in Adiaspiromycosis
Adiaspiromycosis, a rare fungal infection caused by Emmonsia crescens, can be challenging to diagnose due to its similarity with other pulmonary infections. The differential diagnosis for adiaspiromycosis involves ruling out other conditions that may present with similar symptoms and radiological features.
Key Differential Diagnoses
- Tuberculosis: A bacterial infection that can cause similar lung lesions and symptoms, making it a primary differential diagnosis in patients who have traveled to areas where TB is prevalent [1].
- Histoplasmosis: Another fungal infection that can cause pulmonary lesions and symptoms similar to adiaspiromycosis, particularly in individuals who have been exposed to contaminated soil or bird droppings [2].
- Coccidioides immitis: A fungus that can cause a lung infection with similar radiological features to adiaspiromycosis, although it is more commonly found in the southwestern United States and Latin America [8].
Diagnostic Challenges
The differential diagnosis of adiaspiromycosis can be further complicated by the fact that Emmonsia crescens has not been cultured from human clinical specimens, making it difficult to confirm a diagnosis based on laboratory tests alone [6]. In such cases, histopathological examination and molecular biology techniques may be employed to aid in the diagnosis [3].
Treatment Considerations
While adiaspiromycosis is generally considered an incidental finding, treatment may be warranted if there is systemic or pulmonary invasion. Itraconazole and Ketoconazole have been used as antifungal treatments for this condition [7].
In summary, differential diagnosis plays a crucial role in the management of adiaspiromycosis, requiring healthcare providers to consider a range of conditions that may present with similar symptoms and radiological features.
References:
[1] GM Anstead (2012) - Adiaspiromycosis is primarily a pulmonary infection of rodents, fossorial mammals, and their predators and is caused by the soil fungi Emmonsia crescens and ...
[2] by JM Dot (2009) - The diagnosis of adiaspiromycosis due to Emmonsia crescens was initially made using molecular biology techniques.
[3] by M Otčenásek (1975) - The differential diagnosis of the agent of adiaspiromycosis is discussed and attention is called to confusion of the species E. crescens and E. parva in the ...
[6] GM Anstead (2012) - Diagnosis of adiaspiromycosis.
[7] by H Koneru (2017) - The diagnosis is by histopathology with culture. Treatment is warranted if there is systemic or pulmonary invasion.
[8] by M Otčenásek (1975) - The differential diagnosis of the agent of adiaspiromycosis is discussed and attention is called to confusion of the species E. crescens and E. parva in the ...
Additional Differential Diagnoses
- Coccidioides immitis
- tuberculosis
- histoplasmosis
Additional Information
- relatedICD
- http://example.org/icd10/J38.2
- oboInOwl#hasOBONamespace
- disease_ontology
- oboInOwl#id
- DOID:0050072
- oboInOwl#hasDbXref
- MESH:C000656784
- IAO_0000115
- A primary systemic mycosis that is a fungal infection located_in lungs, or located_in skin, which results_in disseminated granulomatous pulmonary process and cutaneous infection in rodents, small wild mammals and humans, has_material_basis_in Chrysosporium parvum or Emmonsia crescens.
- oboInOwl#inSubset
- http://purl.obolibrary.org/obo/doid#DO_infectious_disease_slim
- rdf-schema#domain
- https://w3id.org/def/predibionto#has_symptom_141
- owl#annotatedSource
- t328081
- core#notation
- DOID:0050072
- rdf-schema#label
- adiaspiromycosis
- rdf-schema#subClassOf
- t328428
- 22-rdf-syntax-ns#type
- http://www.w3.org/2002/07/owl#Class
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