Emmonsia crescens is a saprophytic fungus that is distributed worldwide, causing diseases mostly in rodents. It has also been described, though rarely, as an etiologic agent of pulmonary pathology in humans, potentially leading to death. A case of pulmonary adiaspiromycosis is reported in a 30-year-old immunocompetent man. The patient presented with a history of several weeks of weakness, cough, fever, and weight loss of 10 kg. Clinical and radiographic findings showed pulmonary lesions consistent with tuberculosis or histoplasmosis, but no pathogen was found with classical microbiological procedures. The diagnosis of adiaspiromycosis due to Emmonsia crescens was initially made using molecular biology techniques. Histological observations subsequently confirmed the presence of adiaspores in granulomas. To our knowledge, this is the first case of adiaspiromycosis diagnosed by PCR and sequencing. The patient was treated with itraconazole and was seen at 1 month with symptomatic improvement. Here we will discuss this rare fungal infection and its difficult treatment and diagnosis. As represented in this case, molecular biology is a powerful method to optimize diagnostic tests and therefore improve the care of the infected patient.

Molecular Diagnosis of Disseminated Adiaspiromycosis Due to Emmonsia crescens

Lung tissue of 156 rodents (genera Apodemus, Myodes, Microtus,
and Muscardinus) from the Czech Republic, 29 rodents of the
species Spalax ehrenbergi from Israel and 106 rodent specimens
from Africa (genera Heliophobius, Mastomys, Acomys, Aethomys,
Saccostomus, Tatera, Mus, Cryptomys, Dasymys, Dendromus,
Grammomys, and Steatomys) were examined for presence of
adiaspores of the fungal genus Emmonsia. In the Czech Republic,
nine (5.8 %) animals revealed adiaspores of E. crescens. The
positive samples were found in rodents sampled in three of the
five Czech areas studied. Out of six species of the Czech
rodents, three species were positive: Apodemus flavicollis,
Myodes glareolus and Microtus agrestis. A. flavicollis was the
most frequently infected species, whereas A. sylvaticus,
Microtus subterraneus and Muscardinus avellanarius were
negative. Adiaspores were recorded in five females and four
males. A significant preference of the fungus for the host sex
was not observed. Tissue samples of rodents from Africa and
Israel were all negative.

Kucera K

Papers

Human adiaspiromycosis due to fungus Emmonsia crescens sp. n. Emmons et Jellison 1960

[Clinical aspects and therapy of lung adiaspiromycosis in an 11-year-old boy].