Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Eight-Year Surveillance of Candida albicans Bloodstream Infections in an ICU in Turkey 150762 10.22034/cmm.2025.345430.1676 EN Süleyha Hilmioğlu-Polat Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Ege, Izmir, Turkey Dilek Yeşim-Metin Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Ege, Izmir, Turkey Melike Yaşar Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Ege, Izmir, Turkey Aylin Döğen Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Mersin, Mersin, Turkey Ayşe Serin Department of Forensic Medicine, Faculty of Medicine, University of Cukurova, Adana, Turkey Mehmet Sami Serin Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Mersin, Mersin, Turkey Ramazan Gümral Department of Microbiology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey Mohsen Seyedmousavi Center of Expertise in Microbiology, Infection Biology and Antimicrobial Pharmacology, Tehran, Iran Haleh Rafati Center of Expertise in Microbiology, Infection Biology and Antimicrobial Pharmacology, Tehran, Iran Somayeh Sharifynia Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran Yalda Tamaddon Department of Small Animal Internal Medicine, Faculty of Specialized Veterinary Sciences, Science and Research Branch, Islamic Azad University (IAU), Tehran, Iran Ali Tolooe Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada Ayatollah Nasrollahi Omran Department of Mycology, Faculty of Medical Sciences, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran Macit Ilkit Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Çukurova, Adana, Turkey Corné H.W. Klaassen Department of Medical Microbiology and Infectious Diseases, Erasmus−MC University Medical Center, Rotterdam, The Netherlands Amir Syedmousavi Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, United States of America 0000-0002-6194-7447 Journal Article 2025 05 07 <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Background and Purpose:<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Although the distribution of Candida species has shifted over the past three decades, Candida albicans remains the leading cause of nosocomial bloodstream infections. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Materials and Methods: <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This study examined the genetic diversity and antifungal susceptibility of 174 independent C. albicans bloodstream isolates obtained from intensive care unit <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">patients in Turkey. Microsatellite analysis across five loci identified 21 allelic genotypes for elongation factor 3 (CEF3), 12 for carbonic anhydrase III (CAIII), 11 for LOC4, 11 for zinc finger transcription factor-1 (ZNF1), and 9 for killer toxin-resistance protein-6 (KRE6). The multiplex analysis yielded 104 different multi-loci allelic combinations for the 174 strains analyzed, resulting in a discriminatory power of 0.98. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Results: Locus-by-locus microsatellite analysis revealed that certain C. albicans strains from the intensive care unit shared identical genotypes. The geometric mean minimum inhibitory concentrations of antifungal agents, in ascending order, were 0.02 mg/L for itraconazole, voriconazole, and posaconazole, 0.03 mg/L for anidulafungin, 0.13 mg/L for caspofungin, 0.20 mg/L for flucytosine, 0.62 mg/L for fluconazole, and 0.67 mg/L for amphotericin B<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; mso-bidi-language: AR-YE;">Conclusion:<span style="font-size: 6.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-YE;"> Our study showed considerable genetic diversity among bloodstream C. albicans isolates, while antifungal resistance remained uncommon. No significant association was observed between antifungal susceptibility and the genotypes analyzed. The presence of identical genotypes among certain strains points to an endogenous origin and a potential common source of infection within the hospital, warranting further investigation<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; background: white;">. <span style="font-size: 10.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">

https://cmm.mazums.ac.ir/article_150762_05370c90ce16bdd5071cb8bb53394de4.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Prevalence, Risk factors, and Outcome of Invasive Fungal Infections in Hematopoietic Stem Cell Transplant Recipients: a prospective cross-sectional study from Iran 1690 1690 10.22034/cmm.2026.345450.1690 EN Nastaran Keyhanian Department of Infectious Diseases, Shahid Rajaei hospital, Mazandaran University of Medical Sciences, Tonekabon, Iran Mohammadreza Salehi Research center for antibiotic stewardship & antimicrobial resistance, Department of Infectious Diseases, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran 0000-0002-1987-5929 Seyed Ali Dehghan Manshadi, Research center for antibiotic stewardship & antimicrobial resistance, Department of Infectious Diseases, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran Seied Asadollah Mousavi Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran Research Institute for Oncology, Hematology and Cell therapy, School of Medicine, Mohammad Vaezi Hematology, Oncology and Stem Cell Transplantation Research Center, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran Research Institute for Oncology, Hematology and cell therapy, School of Medicine, Tehran Mohsen Meidani Research center for antibiotic stewardship & antimicrobial resistance, Department of Infectious Diseases, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran Mohammad Solduzian Shahid Akbarabad Clinical Research Development Unit (SHACRDU), School of medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran 0000-0002-7504-5065 Marzieh Shahrabi Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Kazem Ahmadikia Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 0000-0003-1745-196X Sahar Tavakoli Shiraji Hematology, Oncology and Stem Cell Transplantation Research Center, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran Research Institute for Oncology, Hematology and cell therapy, School of Medicine, Tehran Murat Akova Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Medical School, Ankara, Turkey Johan Maertenes Department of Microbiology, Immunology, and Transplantation, K.U. Leuven, Leuven, Belgium Department of Hematology, U.Z. Leuven, Leuven, Belgium Neda Alijani Department of Infectious Diseases, Dr. Shariati Hospital, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran Journal Article 2025 06 01 Objectives: Invasive fungal infections (IFIs) are the second leading cause of infection in hematopoietic stem cell transplant (HSCT) recipients. Although knowledge of the local epidemiology of breakthrough IFIs should be considered in terms of guiding organizational effective antifungal prophylaxis strategy, however, institutional approach for ongoing surveillance of the rates and epidemiology of IFIs in high-risk patients like HSCT has been less appreciated. Therefore, this study was aimed to investigate the prevalence, risk factors, and outcome of IFIs in HSCT patients. Method: A prospective study was carried out between March 2021 and March 2022 in HSCT wards of an educational – medical hospital of Tehran University of Medical Sciences to rate the incidence of IFIs. All HSCT recipients were enrolled except those who had incomplete files, had a history of previous corticosteroids receipt for rheumatologic or immunologic disorders, or did not consent. Upon suspicion of IFIs, the appropriate sample was collected for mycological assay. Those with proven/ probable IFIs according to the consensus criteria defined by EORTC/MSG were only counted for evaluation the prevalence, risk factor and outcome of the IFIs. Results: A total of 330 HSCT recipients were enrolled. The prevalence of IFIs was 9.6 %, with aspergillosis as the most frequent one being observed in 97 % of the cases. Pulmonary involvement was the most frequent clinical presentation (78.1 %). Most of IFIs were developed before engraftment (90.6%). CMV infection and acute myeloid leukemia (AML) significantly raised the odds ratio of IFIs development (odds ratios of 1.07 and 12.6; p-values of 0.002 and < 0.001, respectively). The mortality rate was 12.5 %. CMV infection, lower age and HLA-mismatch related donor were factors significantly associated with fatality of IFIs (odds ratios of 15.5, 1.07 and 10.70; p-values of 0.005, 0.002 and 0.016 respectively). Conclusion: IFIs were found to be relatively common complication of allogenic HSCT and continue to be associated with poor prognosis. CMV infection can be independently associated with IFIs and unfavorable outcomes, while HSCT HLA mismatch donors increase the risk of unfavorable outcomes. As a result, tailoring antifungal prophylaxis in these group of high risk hosts is crucial.

https://cmm.mazums.ac.ir/article_150769_74456719f0f4147b55551974a0320474.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 12 05 Thyme essential oil nanoemulsion enhances fluconazole efficacy in resistant Candida glabrata and Candida krusei 1656 1656 10.22034/cmm.2025.345402.1656 EN Donya Nikaein Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran 0000-0003-2333-3361 Seyed Mehdi Joghataei Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran 0000-0002-1572-9473 Javad Malakootikhah Researcher and Ph.D. graduate in Nanobiotechnology, University of Tehran, Tehran, Iran 0000-0002-3262-012X Alireza Shahabi Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran Erfan Alihosseini Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran Alireza Khosravi Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran 0000-0002-6777-5930 Journal Article 2025 04 07 <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Background and Purpose:<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Candidiasis is a common fungal infection, with increasing cases caused by resistant non-albicans species, such as Candida krusei and Candida glabrata. These species present remarkable clinical treatment challenges due to their resistance, particularly with azole antifungals, like fluconazole (FLZ). This study aimed to evaluate the antifungal potential of thyme (Thymus vulgaris) essential oil nanoemulsion (TEONE) against these resistant Candida strains, focusing on its impact on resistance gene expression and the enhancement of conventional treatment efficacy. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Materials and Methods: <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">TEONE was formulated by combining thyme EO with Tween 80 and water using the antisolvent precipitation method to create a stable nanoemulsion. The<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">TEON was characterized by using Scanning Electron Microscopy<span style="font-size: 10.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; letter-spacing: -.2pt;"> <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">for morphology, dynamic light scattering<span style="font-size: 10.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; letter-spacing: -.2pt;"> <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">for particle size, and zeta potential for stability and surface charge assessment. The antifungal activity of TEONE, Thyme EO, and FLZ was assessed against Candida strains using disk diffusion, microdilution, and checkerboard assays. The<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">quantitative reverse transcription polymerase chain reaction was employed to evaluate the expression of resistance genes (ABC1, CDR1, and ERG11) following treatment. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Results: <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Scanning Electron Microscopy<span style="font-size: 10.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; letter-spacing: -.2pt;"> revealed a predominantly spherical morphology with minimal rod-shaped particles, while Dynamic Light Scattering<span style="font-size: 10.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; letter-spacing: -.2pt;"> confirmed a mean droplet size of 134.3 nm and a polydispersity index of 0.402, indicating good dispersion. Zeta potential analysis showed a value of -78.6 mV, suggesting strong stability of nanoemulsion. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> TEONE demonstrated significant antifungal activity, reducing minimum inhibitory concentration values by up to 50%, compared to Thyme EO (p<0.05). Disk diffusion tests showed larger inhibition zones for TEONE (20-25 mm), compared to Thyme EO (15-18 mm) (p<0.01). <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">The<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">quantitative reverse transcription polymerase chain reaction revealed that TEONE reduced CgCDR1 expression by up to 49% in Candida glabrata and downregulated ERG11 and ABC1 in Candida krusei (p<0.05)<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; mso-bidi-language: AR-YE;">Conclusion:<span style="font-size: 6.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-YE;"> While FLZ alone tended to increase resistance gene expression, combining TEONE with FLZ mitigated this effect and enhanced antifungal efficacy, indicating an additive interaction. TEONE represents a promising natural approach for enhancing antifungal treatment strategies against resistant Candida infections, offering potential benefits as an alternative or complementary therapy to conventional antifungal agents. These nanoemulsions may also allow for a reduction in the dosage of traditional drugs such as FLZ, potentially minimizing side effects and the development of resistance<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; background: white;">.

https://cmm.mazums.ac.ir/article_150755_0aeef3848a8aef5380603e2914e9c4ff.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 06 03 Establishment of Aspergillus fumigatus-specific IgG cut-off level for diagnosis of chronic pulmonary aspergillosis in the Iranian population 1741 1741 10.22034/cmm.2026.345514.1741 EN Sabrieh Asadi Shahi Sarae Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 0000-0002-0951-5823 Masoud Aliyali Pulmonary and Critical Care Division, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran Vida Mortezaee Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Hamidreza Jamaati Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Hossein Asgarian Omran Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Siavash Abedi Pulmonary and Critical Care Division, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran Hossein Mehravaran Pulmonary and Critical Care Division, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran Jamshid Yazdani Charati Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran Maryam Sadat Mirenayat Pulmonary Rehabilitation Research Center (PRRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Mihan Pourabdollah Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Somayeh Lookzadeh Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Maryam Moazeni Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 0000-0001-6581-2139 Sabah Mayahi Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 0000-0002-9264-8984 Mona Ghazanfari Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran 0000-0002-3045-9125 Iman Haghani Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran 0000-0001-9723-7618 Mahdi Abastabar Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 0000-0002-0016-2849 Mohammad T Hedayati Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 0000-0001-6415-4648 Journal Article 2025 10 08 <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Background and Purpose:<span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The optimal cut-off level for serum Aspergillus-specific IgG (SAfIgG) in the diagnosis of chronic pulmonary aspergillosis (CPA) remains to be established for different countries. This study aimed to establish a cut-off level for SAfIgG in CPA diagnosis and validate its diagnostic accuracy in the Iranian population. <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Materials and Methods: <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">Diagnostic performance of SAfIgG was evaluated in patients with chronic obstructive pulmonary disease (COPD) suspected of having CPA who had referred to the two reference centers for pulmonary diseases in Iran, during 2021-2023. Levels of SAfIgG were measured using an enzyme-linked immunosorbent assay. Optimal cut-off point for SAfIgG was determined using the receiver operating characteristics (ROC) curve and Youden's index and was subsequently validated. <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Results: <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">In total, 30 (15.3%) out of 196 COPD patients were diagnosed with CPA. The ROC curve analysis yielded an area under the curve of 0.632 (95% CI: 0.421-0.843; p=0.114), with an optimal cut-off value of 23.5 U (sensitivity: 71.4%; specificity: 61.4%). The SAfIgG levels were significantly higher in CPA patients (median [IQR], 39 [31-55] U) compared with non-CPA patients (20 [15-24] U; p<0.001). <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Conclusion: <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-SA;">The findings indicated that SAfIgG, with a cut-off value of 23.5 U, provided moderate sensitivity and specificity for screening and may be used in combination with the culture method to confirm the diagnosis of CPA in COPD patients. However, the variability in cut-off values across different populations highlights the need for standardized guidelines to improve diagnostic consistency and reliability.

https://cmm.mazums.ac.ir/article_150770_31d3c9c81e6b0aaf9c0c178e762a7019.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Nigella sativa-based agar medium for identifying Cryptococcus neoformans 1772 1772 10.22034/cmm.2026.345553.1772 EN Hossein Khodadadi Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 0000-0001-9507-8764 Ghasem Mohammadi Nematabad Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Faezeh Rouhi Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Erfan Khodadadi Faculty of Medicine, Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, Iran Journal Article 2025 12 09 <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Background and Purpose:<span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> Cryptococcus neoformans is an important opportunistic fungus that causes severe infections, including cryptococcal meningitis, especially in immunocompromised patients. One of its key characteristics is the ability to produce melanin from melanin precursors. This pigmentation serves as a useful marker to distinguish fungus colonies from other yeasts when grown on selective media, such as bird seed agar (BSA). However, the complicated preparation of medium and high cost of commercial BSA restrict its routine application. This study aimed to present and assess a new culture medium prepared from black seed (Nigella sativa) meal extract (NSME) as an affordable and more accessible alternative to BSA for the identification of C. neoformans. <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Materials and Methods: Various NSME-based media formulations, with and without <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">N. sativa oil (NSO), were prepared and tested against type strains, clinical and environmental isolates of <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Cryptococcus species, and other medically relevant yeasts. Growth rate and melanin-associated pigmentation of the yeast colonies were assessed during 14 days of incubation. <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Results: The<span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> NSME media effectively promoted the growth and melanin production of <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">C. neoformans with colony pigmentation ranging from light to dark brown depending on NSME concentration. In contrast, NSO had minimal impact on growth or pigmentation. Addition of 1% glucose to newly developed media enhanced growth rates, aligning colony sizes with those observed on Sabouraud dextrose agar. Non-melanin producer yeasts, such as <span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Candida spp. and Saccharomyces cerevisiae<span style="mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; font-style: normal;">, showed limited growth and no pigmentation, facilitating species differentiation. <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Conclusion: The<span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> NSME-based culture media offer a reliable, low-cost alternative for the growth and preliminary identification of C. neoformans, with promising potential for use in routine diagnostics, especially in low-resource settings.

https://cmm.mazums.ac.ir/article_150772_6f1439da4d130263568eecba53ece93e.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 06 07 Risk factors, clinical profiles, and fungal etiology of toenail onychomycosis among female traders in a central province of Vietnam 1710 1710 10.22034/cmm.2026.345480.1710 EN Kieu-Anh Thi Tran Paediatric Department, Internal Medicine, Department of Postgraduate Education, Vinh Medical University, Vinh, Nghe An, Vietnam 0000-0003-2951-8359 Khanh-Linh Thi Duong Thai Thuong Hoang Hospital, Vinh, Nghe An, Vietnam Thang Doang Thai Thai Thuong Hoang Hospital, Vinh, Nghe An, Vietnam Anh Ngoc Do Department of Parasitology, Vietnam Military Medical University, Ha Dong, Ha Noi, Vietnam 0000-0001-6086-7659 Loi Ba Cao Scientific and Training Management Department, National Institute of Malariology, Parasitology and Entomology, Ha Noi, Vietnam 0009-0002-8203-0037 Tran-Anh Le Department of Parasitology, Vietnam Military Medical University, Ha Dong, Ha Noi; Microbiology and Molecular Biology Department, National Hospital for Tropical Diseases, Hanoi, Vietnam 0000-0002-4919-1739 Journal Article 2025 08 24 Background and Purpose: Hot and humid climate of Vietnam favors fungal infections; however, data on toenail onychomycosis in this region remain limited. In this regard, the present study aimed to investigate risk factors, clinical features, and causative agents of toenail onychomycosis in Vietnam. Materials and Methods: This cross-sectional study was conducted in Nghe An province, Vietnam, from March 2021 to August 2022. Toenail samples from female traders with suspected onychomycosis underwent direct examination and culture. Isolates were identified using conventional and molecular techniques, including restriction fragment length polymorphism analysis and sequencing of the internal transcribed spacer region. Results: Based on findings, 45.5% of 224 participants were diagnosed with onychomycosis. The identified risk factors for onychomycosis were water contact (odds ratio (OR) 2.434; 95% confidence interval (CI) 1.098–5.383) and nail grooming (OR: 2.096; 95% CI: 1.002–4.384). Distal and lateral subungual onychomycosis was the most common form (84.3%), followed by superficial white (8.8%) and proximal subungual form (6.9%). Most cases were classified as mild (35.3%) or moderate (40.2%) infections, with an average onychomycosis severity index (OSI) score of 10.25 ± 8.09. Yeasts accounted for 70.6% of cases, and Candida was the leading genus (54.9%), followed by Trichosporon (13.7%) and Geotrichum (1.9%). Most mold-related cases were caused by non-dermatophyte fungi, including Aspergillus (16.7%), Penicillium (5.9%), Curvularia (2.9%), Fusarium (2.0%), and Talaromyces (1%), while dermatophyte (Trichophyton) was identified in only one case (1%). Compared with yeast infections, mold-related cases were more associated with older participants and a higher rate of severe cases (43.3% vs. 16.7%, p = 0.010) as well as OSI score (13.6 ± 8.2 vs. 8.8 ± 7.7, p = 0.006). Conclusion: Both behavioral and occupational factors were risks for toenail onychomycosis, which was mostly mild to moderate and associated with yeasts. Non-dermatophyte molds were less frequent but linked to more severe cases. Targeted prevention and tailored treatment strategies are needed.

https://cmm.mazums.ac.ir/article_150771_17dc70e0167c29b78fc345cb42271cba.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Clinical, mycological, and antifungal susceptibility testing of causative agents of fungal keratitis from North India 1692 1692 10.22034/cmm.2025.345456.1692 EN Ankita Saroya Advanced Eye Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India Amit Gupta Advanced Eye Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Chintan Malhotra Advanced Eye Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Arpita Khamrai Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Snigdha Reddy Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Shivaprakash M Rudramurthy Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Harsimran Kaur Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Anup Ghosh Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. 0000-0002-0341-6680 Journal Article 2025 06 09 Background and Purpose: Fungal Keratitis (FK) is a sight-threatening corneal infection resulting in monocular blindness. FK occurs more frequently in warm, humid tropical and subtropical regions, particularly those with an agriculture-based economy. The present study aims to check the spectrum of organisms causing FK and analyze the associated clinical features. Antifungal susceptibility patterns also determined with isolated organisms in a tertiary care center in North India. Materials and Methods: This study was conducted on suspected FK cases recruited from January 2020 through December 2023 in the Advanced Eye Centre (AEC) Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh. The routine mycological laboratory data, including direct microscopy (KOH mount) and culture on Sabouraud’s Dextrose agar media (SDA), were collected. The clinical data and etiological factors were analysed by retrieving medical records. Further, the preserved isolates were subjected to antifungal susceptibility testing as per the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method (M38-A2) for a panel of antifungals, including VRCZ (voriconazole), ITRA (itraconazole), PSCZ (posaconazole), LLCZ (luliconazole), MCZ (miconazole), KTZ (ketoconazole), AMB (amphotericin-B), NTM (natamycin), and TFH (terbinafine-hydrochloride). Results: Of a total of 2891 suspected cases, 677 were found to be positive by either microscopy or culture. Of the 677 positive cases, 470 were culture-positive, 383 (56.57%) were both microscopy as well as culture-positive, 206 (30.42%) were culture-negative but microscopy-positive, and 87 (12.85%) were culture-positive but microscopy-negative. In the geographical zones from , Punjab was leading with 39.29% of cases, followed by Haryana (26.14%), Uttar Pradesh (14.33%), and Himachal Pradesh (14.03%). Aspergillus spp. was found to be the predominant etiologic agent accounting for (N=198/470) 42.12%, followed by Fusarium spp. (N=173/470) 36.80%, dematiaceous fungi (N=71/470) 15.10%. Clinical details of all 677 patients were successfully retrieved and found that vegetative trauma was the major associated etiological factor causing FK. Other etiological factors involved animal tails, dust, insects, foreign bodies, chemicals, or iron piece injuries. AFST results revealed that VRCZ, ITRA, and LLCZ exhibit low MIC values against Aspergillus spp. and Fusarium spp. VRCZ exhibits a median MIC range of 0.25µg/ml among Aspergillus spp. and 0.5µg/ml among Fusarium spp. and the dematiaceous group of fungi. Conclusion: Aspergillus spp. represents the predominant etiology causing FK, followed by Fusarium spp., but dematiaceous fungi seem to pose a significant threat in causing FK. In-vitro susceptibility results revealed that with VRCZ, LLCZ can also be a promising antifungal drug for the treatment of FK.

https://cmm.mazums.ac.ir/article_150764_748d1fb2d15d17998b2e3e8c0de16ff7.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Bloodstream infection by Fusarium Solani Complex in a paediatric patient affected by acute lymphoblastic leukaemia and P450 cytochrome polymorphism: A case report 150774 10.22034/cmm.2025.345277.1568 EN Francesco De Leonardis Division of Paediatric Haematology-Oncology, University of Bari, P.zza Giulio Cesare 11, 70124 Bari, Italy Vittorio Greco Miani Division of Paediatric Haematology-Oncology, University of Bari, P.zza Giulio Cesare 11, 70124 Bari, Italy 0009-0003-5723-7842 Vittoriana De Laurentiis UOC Microbiology and Virology, Azienda Ospedaliera-Universitaria Policlinico of Bari, 70124 Bari, Italy Michele Mastria UOC Microbiology and Virology, Azienda Ospedaliera-Universitaria Policlinico of Bari, 70124 Bari, Italy Mariachiara Servedio Division of Paediatric Haematology-Oncology, University of Bari, P.zza Giulio Cesare 11, 70124 Bari, Italy Enza Pentassuglia Division of Paediatric Haematology-Oncology, University of Bari, P.zza Giulio Cesare 11, 70124 Bari, Italy 0009-0008-0372-3868 Roberta Koronica Division of Paediatric Haematology-Oncology, University of Bari, P.zza Giulio Cesare 11, 70124 Bari, Italy Angela Vinella Department of Biomedical Sciences and Human Oncology, University of Bari. Piazza Giulio Cesare 11, Bari 70124, Italy. 0000-0002-9813-8475 Maria Addolorata Mariggiò Department of Biomedical Sciences and Human Oncology, University of Bari. Piazza Giulio Cesare 11, Bari 70124, Italy. Nicola Santoro Division of Paediatric Haematology-Oncology, University of Bari, P.zza Giulio Cesare 11, 70124 Bari, Italy 0000-0001-8853-6536 Journal Article 2024 08 04 <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Background and Purpose:<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Fusarium <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">species are causative agents of a wide range of opportunistic infections, ranging from superficial to disseminated forms, particularly in nosocomial settings. Children with haematological malignancies may develop severe fungal infections, such as fusariosis, that have proven notoriously challenging to diagnose and treat, with high mortality rates. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Case Presentation: <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">This report aimed to describe an invasive Fusarium bloodstream infection in an eleven-year-old male patient treated for high-risk acute lymphoblastic leukaemia. The patient presented with neutropenic fever and necrotic papular skin lesions. Fusarium solani complex was identified in blood cultures. Initial empirical therapy with voriconazole led to partial improvement, but therapeutic drug monitoring showed persistently low plasma levels. Genetic analysis revealed CYP2C19*17 polymorphism, classifying the patient as an ultrarapid metabolizer. Treatment was switched to liposomal amphotericin B, resulting in clinical recovery. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; mso-bidi-language: AR-YE;">Conclusion:<span style="font-size: 6.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-YE;"> This case highlighted the importance of early diagnosis, targeted antifungal treatment, therapeutic drug monitoring, and pharmacogenetic testing in pediatric Fusarium infections<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; background: white;">.

https://cmm.mazums.ac.ir/article_150774_9f4a748d310947fbea6641ae6fc57332.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Invasive Aspergillus versicolor infection of the oral and vaginal mucosa in a patient with Lichen planus 1638 1638 10.22034/cmm.2025.345382.1638 EN Dima Ibrahim Transplant Infectious Diseases, Burjeel Medical City · Abu Dhabi, UAE. College of Medicine and Health Sciences, Khalifa University · Abu Dhabi, UAE. 0000-0002-4303-1339 Fatima AlDhaheri College of medicine and health sciences, United Emirates University · Abu Dhabi, UAE 0000-0002-5412-6157 Akela Ghazawi College of medicine and health sciences, United Emirates University · Abu Dhabi, UAE 0000-0003-2552-4807 Seema Oommen Microbiology, Burjeel Medical City, MBZ city, Musaffah, United Arab Emirates 0000-0002-0728-7783 Journal Article 2025 03 03 <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Background and Purpose:<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Invasive aspergillus stomatitis and vaginitis are relatively rare in a patient with Oral Lichen planus and a history of steroid and antibiotic use. <span style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Case Presentation: <span style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">A 49-year-old female diagnosed with lichen planus presented with severe stomatitis and cheilitis and was treated with fluconazole as the clinical appearance resembled thrush. Recurrence of her symptoms despite adequate treatment led to culture from the lesions, which repeatedly grew Aspergillus spp., an unlikely pathogen at this site. Sequencing further identified the isolate as Aspergillus versicolor. Antifungal treatment was initiated, first with micafungin and then with voriconazole. The patient responded and was discharged, only to return with a relapse of symptoms. Environmental samples from her house revealed the same Aspergillus spp. The patient responded to isavuconazole and was discharged home after thorough house decontamination, with no recurrence of lesions on follow-up. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; mso-bidi-language: AR-YE;">Conclusion:<span style="font-size: 6.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-YE;"> Aspergillosis should be considered a differential diagnosis in mucosal lesions that are difficult to treat in both immunocompetent as well as immunocompromised individuals<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; background: white;">.

https://cmm.mazums.ac.ir/article_150775_0f799a9211cbb154a60d561c5338d3f0.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Report of a rare case of tinea capitis favosa caused by Trichophyton schoenleinii in Iran 1695 1695 10.22034/cmm.2025.345462.1695 EN Leila Hosseini Pour Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Seyed Jamal Hashemi Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 0000-0002-2638-5004 Zeinab Borjian Boroujeni Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Abolfathi Department of Medical Biotechnology, Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. Muhammad Ibrahim Getso Department of Medical Microbiology and Parasitology, College of Health Sciences, Bayero University, PMB, 3011, Kano, Nigeria 0000-0002-0752-702X Omid Raiesi Department of Parasitology, School of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran. 0000-0003-2382-550X Journal Article 2025 06 13 <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Background and Purpose:<span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Favus, a severe form of tinea capitis, is primarily caused by Trichophyton schoenleinii and can lead to permanent scarring alopecia if untreated. Although its prevalence has declined globally, outbreaks persist in regions with socioeconomic challenges and immigrant populations. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Case Presentation: <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Arial; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">We report an 8-year-old Afghan boy residing in Iran who presented with diffuse alopecia and erythematous, purulent scalp lesions. Direct microscopy, culture, and ITS-PCR confirmed infection with T. schoenleinii. The isolate exhibited high susceptibility to itraconazole, ketoconazole, and terbinafine, with reduced activity for fluconazole. Treatment with topical ketoconazole and oral itraconazole (5 mg/kg/day for six months) resulted in clinical resolution. <span style="font-size: 9.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; color: #2e74b5; mso-bidi-language: AR-YE;">Conclusion:<span style="font-size: 6.0pt; line-height: 85%; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi; mso-bidi-language: AR-YE;"> Early recognition of favus, coupled with accurate identification and susceptibility-guided therapy, is crucial to prevent long-term complications. Surveillance of T. schoenleinii in vulnerable populations, including immigrants, remains vital to inform public health strategies and mitigate the risk of re-emergence.

https://cmm.mazums.ac.ir/article_150766_2c58d4724efe17135a063eb38bbb2ab1.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Disseminated Cryptococcosis in a patient with idiopathic chylothorax and chylous ascites treated with a denver peritoneo-venous shunt: a case report and review of the literature 1689 1689 10.22034/cmm.2025.345449.1689 EN Kyotaro Kawase Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan Yoshitaka Wakabayashi Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan Shin Nakayama Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan Ai Yamamoto Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan Kiichi Watanabe Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan Masayoshi Yamamoto Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan Takatoshi Kitazawa Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan 0000-0002-2350-2922 Journal Article 2025 05 30 <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Background and Purpose:<span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> Disseminated cryptococcosis is an opportunistic infection in immunocompromised individuals. Chronic idiopathic chylothorax and chylous ascites can cause immunodeficiency via loss of immunoglobulin and lymphocytes in the late stage. <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Case presentation<span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">: This study aimed to present a case of disseminated cryptococcosis shortly after duodenal perforation in an immunocompetent patient with idiopathic chylothorax and chylous ascites that had been treated with a Denver peritoneo-venous shunt. Diagnosis of dissemination was confirmed by positive cryptococcal culture of blood, pleural effusion, ascites, and the removed shunt. The patient had low CD4+ lymphocytes and hypogammaglobulinemia at the onset of cryptococcosis. <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Conclusion: It should be noted that cryptococcosis can also occur in cases of idiopathic chylothorax and chylous ascites with low CD4+ or gamma globulin levels. <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Keywords: Denver peritoneo-venous shunt, Disseminated cryptococcosis, Duodenal perforation, Chylothorax, Chylous ascites

https://cmm.mazums.ac.ir/article_150767_398c52b1552f17ebc3b31b04fd254e54.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Subcutaneous Phaeohyphomycosis caused by the rare emerging fungus Parathyridaria percutanea 1731 1731 10.22034/cmm.2026.345496.1731 EN Manharpreet Kaur Department of Microbiology, Christian Medical college and Hospital Ludhiana, Punjab, India Department of Microbiology, Civil Hospital, Nawanshahr, Punjab, India 0009-0006-9430-070X Haseen Ahmad Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Manpreet Kaur Department of Pathology, Civil Hospital, Nawanshahr, Punjab, India Satwinderpal Singh Department of General Surgery, Civil Hospital, Nawanshahr, Punjab, India Harsimran Kaur Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Rupinder Singh Department of Microbiology, Civil Hospital, Nawanshahr, Punjab, India Mani Bhushan Kumar Department of Microbiology, Christian Medical College and Hospital, Ludhiana, Punjab, India 0009-0006-9430-070X Shivaprakash M Rudramurthy Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India 0000-0002-9097-9253 Journal Article 2025 09 25 <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Background and Purpose:<span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; letter-spacing: .15pt; mso-bidi-language: AR-YE;"> <span style="font-size: 9.0pt; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;">Parathyridaria percutanea is an emerging human fungal pathogen that primarily causes subcutaneous phaeohyphomycosis. Molecular sequencing is an accurate and definitive method for identification. Treatment can be achieved through either surgical intervention or antifungal therapy. <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Case Presentation: This study aimed to report a rare case of Parathyridaria percutanea subcutaneous phaeohyphomycosis in a 62-year-old diabetic woman presenting with a forearm swelling. Diagnosis was confirmed by molecular sequencing after culture yielded non-sporulating hyphae. The patient underwent surgical excision followed by short-course itraconazole, with complete resolution and no recurrence on one-year follow-up. <span style="font-size: 9.0pt; font-family: 'Times New Roman',serif; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi; color: #2e74b5; letter-spacing: .15pt; mso-bidi-language: AR-YE;">Conclusion: This case highlighted that P. percutanea subcutaneous phaeohyphomycosis is a rare organism isolated from a clinical case. In cases where non-sporulating morphology delays diagnosis, molecular tools provide reliable identification, while surgical excision with itraconazole ensures effective management.

https://cmm.mazums.ac.ir/article_150768_a13595e867ef1d8c0e8b93882c0f7ca7.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 07 29 Rare Ocular Foe: A Case of Fungal Keratitis Caused by Podospora bulbillosa 1677 1677 10.22034/cmm.2026.345427.1677 EN Madhu Rai Ocular Microbiology Service, Shantilal Shanghvi Eye Institute, Wadala East, Mumbai, Maharashtra, India 0009-0000-6924-1214 Vaibhav Nagpal Junior Faculty, Cornea Service, Shantilal Shanghvi Eye Institute, Wadala East, Mumbai, Maharashtra, India Chaitali Nikam Haystack Analytics Private Limited SINE, IIT Bombay, Powai, Mumbai, India Anirvan Chatterjee Haystack Analytics Private Limited SINE, IIT Bombay, Powai, Mumbai, India Amrutraj Zade Haystack Analytics Private Limited SINE, IIT Bombay, Powai, Mumbai, India Sourav Das Jhaveri Microbiology Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India Savitri Sharma Ocular Microbiology Service, Shantilal Shanghvi Eye Institute, Wadala East, Mumbai, Maharashtra, India Journal Article 2025 05 07 Background and Purpose Fungal keratitis remains a major cause of corneal blindness, particularly in individuals with ocular trauma or environmental exposure. Accurate and timely identification of the etiologic agent is important for appropriate treatment. This report describes a case of keratitis caused by an uncommon dematiaceous fungus, identified using a sequencing-based approach, highlighting the role of molecular diagnostics in clinical practice. Case presentation A 25-year-old male presented with redness and pain in the right eye after exposure to dust. On slit lamp examination, a 5 mm × 3 mm superficial corneal infiltrate was noted, and the best-corrected visual acuity in the affected eye was 20/50. Corneal scrapings were obtained and examined microscopically, revealing septate fungal filaments. Sample was cultured on Sabouraud Dextrose Agar, which produced rapidly growing, initially colourless colonies that later developed black pigmentation at the margins. To accurately identify the fungal species, DNA was extracted from the culture and analysed using Oxford Nanopore Sequencing targeting the ITS gene. Results The colonies observed on culture suggested the presence of a dematiaceous fungus. Sequencing confirmed the organism as Podospora bulbillosa, a rare fungal species not commonly associated with ocular infections. The patient was started on 5% natamycin eye drops administered topically. Over the course of treatment, the infiltrate showed gradual resolution. Complete clinical recovery was achieved with restoration of visual acuity and no residual scarring or complications noted on follow-up examination. Conclusion This case highlights the utility of molecular diagnostic techniques in the identification of rare fungal pathogens in keratitis. Incorporating sequencing tools can aid in precise pathogen detection and guide targeted therapy. Podospora bulbillosa should be considered as a potential etiological agent in cases of fungal keratitis, especially in settings where exposure to environmental contaminants occurs. Early recognition and appropriate antifungal treatment can result in successful outcomes, even in infections caused by rare fungal species.

https://cmm.mazums.ac.ir/article_150781_37e86b0a26bbd9c74dc5bfe953cac2a8.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 06 26 Orbital infection due to Saksenaea loutrophoriformis in an immunocompetent adolescent: A case report 1697 1697 10.22034/cmm.2026.345464.1697 EN Somayeh Dolatabadi Department of Biology, Hakim Sabzevari University, Sabzevar, Iran Mohammad Hasan Aelami Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Javad Najafzadeh Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Etezad Razavi Ophthalmology, Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Saeid Sasan Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Jos Houbraken Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands Journal Article 2025 07 17 Background and Purpose: Mucormycosis is a rare fungal infection which can cause acute, disfiguring, and angioinvasive infections in immunocompromised patients with high mortality and morbidity rates. However, this study aimed to present the case of a healthy 7-year-old female. Case presentation: An immunocompetent female with orbital mucormycosis caused by Saksenaea loutrophoriformis from Mashhad, Iran was admitted to the hospital. This rare infection was the consequence of an injury due to a tree branch. The causative agent was identified by histopathology, routine mycological methods, and DNA sequencing of the Internal Transcribed Spacer 1 and 2 regions, including the intervening 5.8S gene and the partial large subunit region D1 and D2. Results: The patient was successfully treated with surgical debridement and antifungal treatment of amphotericin B and oral posaconazole. Conclusion: Molecular diagnosis is crucial in the absence of sporulation to avoid misidentification and late diagnosis. This report of a rare infection in an immunocompetent host is valuable for awareness of clinicians.

https://cmm.mazums.ac.ir/article_150773_7fbefb4f947b4b5945ad1f910b934721.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 12 15 Candida auris colonization or infection in the ear of four patients with chronic otitis externa: A case series and literature review 1658 1658 10.22034/cmm.2025.345406.1658 EN Fatemeh Safari Department of Microbiology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran 0000-0001-9509-5708 Shima Aboutalebian Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-0178-4372 Tooraj Khaledian Department of Otolaryngology, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran Elahe Nasri Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-9963-7084 Kazem Ahmadikia Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 0000-0003-1745-196X Journal Article 2025 04 12 Background and Purpose: Candida auris, a globally emerging multidrug-resistant pathogen, was first isolated from the external ear canal of a Japanese patient. Subsequently, most cases were reported from invasive or non-ear infections, while in Iran, the increasing numbers of otologic infections as the dominant clinical form of C. auris infections are being reported. Materials and Methods: In this study, the clinical, microbiological, and outcome of 4 C. auris otomycotic cases that have been identified during our previous large-scale survey on 1,029 patients/specimens in a single center have been described alongside a literature review of C. auris cases reported till 2023 from Iran. Results: Six culture-proven C. auris cases were reported, of which, four belonged to clade V and two to clade I. Three culture negative PCR-identified cases also were documented. The clinical table of the infection in Iran where shows different clade of C. auris is differed from other countries where other clades and other clinical forms like candidemia are predominated. No case of candidemia was noted. Although fluconazole resistance was documented in 50% of the isolates, no resistance to echinocandins and amphotericin B were noted. Conclusion: This review highlights several notable points; (a) C. auris infection is a challenging condition which usually misdiagnosed or diagnosed untimely, (b) the clinical table and cladal distribution of C. auris in Iran is different from other countries, (c) cases with C. auris may provide negative culture, underscoring the importance of utilization of specific direct PCR for ruling out/in C. auris, particularly in cases with chronic otomycosis, (d) ongoing patient follow-up and antifungal susceptibility testing in patients who does do not respond to antifungal drug are recommended, (e) relying on non specific, insensitive, and time-consuming approaches such as culture, not only would postpone the detection, but it could be also misleading for the isolation of C. auris in a setting where molds are predominated.

https://cmm.mazums.ac.ir/article_150757_7096f22cd29d22e7745a2b5cd6064930.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Management of Rhino-Orbital-Cerebral Mucormycosis Infection: Anesthetic Challenges 150765 10.22034/cmm.2025.345516.1743 EN Vali Imantalab Anesthesiology Research Center, Department of Anesthesiology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran. 0000-0001-6444-0329 Mohammad Dodangeh Balakhani Department of Pulmonology, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran Iman Haghani Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 0000-0001-9723-7618 Nazanin Rahmanian Anesthesiology Research Center, Department of Anesthesiology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran. 0000-0001-9591-1795 Erfan Vakili Anesthesiology Research Center, Department of Anesthesiology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran. Reihane Einollahzadeh Anesthesiology Research Center, Department of Anesthesiology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran. Hamid Badali Department of Molecular Microbiology & Immunology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, USA 0000-0002-6010-8414 Nooshin Ahmadvand Department of Infectious Disease, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran 0009-0002-7970-0271 Gelareh Biazar Anesthesiology Research Center, Department of Anesthesiology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran. Journal Article 2025 10 12 Despite the application of surgery and antifungal therapy, rhino-orbital-cerebral mucormycosis is a severe and life-threatening fungal infection with high morbidity and mortality, particularly in immunocompromised patients. This review focuses on the current evidence on the perioperative anesthetic management of rhino-orbital-cerebral mucormycosis, emphasizing the unique challenges its aggressive, angioinvasive nature poses. Key issues include difficult airway management due to fungal debris and supraglottic edema, hemodynamic instability, renal dysfunction because of nephrotoxic antifungal therapy (e.g., amphotericin B), and the critical need for glycemic control in diabetic patients. Case studies illustrate the complexities of managing comorbidities such as post-COVID-19 sequelae, uncontrolled diabetes, and immunosuppression. Preoperative optimization, judicious fluid and electrolyte management, and the use of video laryngoscopy for difficult intubation are highly recommended. By addressing these challenges, this article provides a practical framework for anesthesiologists to enhance perioperative care in patients with ROCM, ultimately improving survival and reducing complications. Awareness of these procedures may help clinicians choose the most effective treatment regimens. However, further studies are warranted to correlate these findings with clinical outcomes.

https://cmm.mazums.ac.ir/article_150765_b71cc4d9375b8588668edae96fcb58ba.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Biological activities and compounds of Volvariella volvacea: A review of their dual roles in health and infection 1712 1712 10.22034/cmm.2026.345482.1712 EN Roman Rafael Bahande Manucdoc Department of Biological Sciences, Central Luzon State University, Science City of Muñoz, Nueva Ecija, Philippines Office of University Research Development, Tarlac State University, Tarlac City, Tarlac, Philippines 0009-0008-3729-4950 Rich Milton R. Dulay Department of Biological Sciences, Central Luzon State University, Science City of Muñoz, Nueva Ecija, Philippines Center for Tropical Mushroom Research and Development, Central Luzon State University, Science City of Muñoz, Nueva Ecija, Philippines Department of Biology, College of Science, De La Salle University, Taft Avenue, Manila, Philippines 0000-0002-5438-878X Journal Article 2025 08 28 Background and Purpose: Volvariella volvacea is an edible mushroom that has been demonstrated to exhibit various biological activities and contain numerous biochemical compounds. However, it was reported to cause invasive infection in immunocompromised patients, affecting their body organs in the process. Infective nature of V. volvacea has not yet been fully elucidated. Although its bioactivities and compounds are considered pharmacologically beneficial, they were examined in this bifaceted review to provide a preliminary explanation for the harmful opportunistic behavior of the fungus. Materials and Methods: Published articles retrieved from Google Scholar were comprehensively consolidated, evaluated, and summarized. Specific keywords, relative to infection reports, biological activities, and compounds of V. volvacea, as well as infective mechanisms of some medically significant fungal pathogens, were used to collect and select studies for this review. Results: Related studies describing the mechanisms of opportunistic and true pathogenic fungal species, as well as other disease-related biological processes, were used as the basis for this review. Based on these findings, V. volvacea may induce systemic infection through its bioactivities and compounds. Overall, these properties may contribute to the growth, survival, proliferation, pathogenicity, and virulence of the fungus during infection. The antioxidant activity may help evade the defense mechanisms of the host, such as the induction of oxidative stress during an infection. Immunomodulatory mechanisms, through increased immunological cells and pro-inflammatory genes, may exacerbate damage within the tissues of the host. Similarly, cytotoxicity may also help worsen the fungal infection by impeding division of healthy cells. Meanwhile, the antimicrobial activity of V. volvacea may aid the outgrowth of both beneficial and pathogenic microorganisms within the host microbiota, resulting in harmful dysbiosis. The initiation of platelet aggregation, which is a defense mechanism against infection, may also be evaded by the fungus through its antiplatelet property. Moreover, the biological compounds of V. volvacea, namely phenols, flavonoids, and β-glucan, may also contribute to infection through their association with the aforementioned biological activities, in addition to their toxicological properties. Conclusion: This review may serve as a basis for future studies to provide a deeper understanding of the infective behavior of V. volvacea, paving the way for improved diagnosis, prognosis, and treatment strategies. In the meantime, adherence to precautionary and biosafety measures when handling V. volvacea, as well as maintaining overall health, is highly encouraged, especially for individuals with frequent exposure to the mushroom.

https://cmm.mazums.ac.ir/article_150782_85146a9c909c7d51adaba8077475cb68.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Inhibition of Candida biofilms by Streptomyces-derived compounds: A systematic review 1682 1682 10.22034/cmm.2025.345437.1682 EN Ismail Ismail Doctoral Student in Biotechnology, Graduate School, Gadjah Mada University, Yogyakarta, Indonesia 0000-0002-0141-602X Sylvia Utami Tunjung Pratiwi Department of Pharmaceutical Biology, Faculty of Pharmacy, Gadjah Mada University, Yogyakarta, Indonesia 0000-0002-3254-9407 Ema Damayanti Research Center for Food Technology and Processing, National Research and Innovation Agency, Yogyakarta, Indonesia 0000-0002-4017-0499 Jaka Widada Department of Agricultural Microbiology, Faculty of Agriculture, Gadjah Mada University, Yogyakarta, Indonesia 0000-0001-5012-3795 Journal Article 2025 05 22 Background and Purpose: Streptomyces, a genus of Actinobacteria, is recognized for its ability to produce diverse bioactive compounds with significant antimicrobial properties. Candida biofilms pose a major clinical challenge due to their high resistance to antifungal agents and evasion of host immune responses. This systematic review evaluated the efficacy and mechanisms of Streptomyces-derived compounds in inhibiting Candida biofilms, with a focus on their potential clinical applications. Materials and Methods: A comprehensive literature search was performed using PubMed, Scopus, ScienceDirect, and LILACS databases, covering studies published between 2016 and 2024. The selection was limited to in vitro studies assessing the effects of Streptomyces-derived compounds on Candida biofilms. Articles were screened based on predefined inclusion and exclusion criteria following PRISMA guidelines. Risk of bias was evaluated using standardized tools. Results: Nine studies met the eligibility criteria. Several Streptomyces species were reported to produce compounds, such as pyrrolo[1,2-a]pyrazine-1,4-dione, bafilomycin derivatives, and sorbicillin, which exhibited strong antibiofilm activity. These compounds have been shown to interfere with biofilm formation through various mechanisms, including disruption of cell membranes and inhibition of hyphal adhesion and development. Notably, Streptomyces olivaceus and Streptomyces chrestomyceticus strains produced secondary metabolites that significantly reduced biofilm formation of Candida species. Conclusion: Compounds derived from Streptomyces offer promising antifungal strategies against biofilm-associated Candida infections. Further research is needed to explore their clinical application in combating antifungal resistance and improving treatment outcomes in healthcare settings.

https://cmm.mazums.ac.ir/article_150756_22a69dd3ced2080188d32622a5f2182c.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Recent advances in targeted therapy of pulmonary fungal infections with a focus on inhaled opelconazole (PC945): a systematic review 1746 1746 10.22034/cmm.2026.345519.1746 EN Nooshin Ahmadvand Department of Infectious Disease, Faculty of Medicine, Guilan University of Medical Science, Rasht, Iran 0009-0002-7970-0271 Hossein Mohammad Taghi Fam Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Iman Haghani Department of Medical Mycology and Invasive Fungi Research Center (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. 0000-0001-9723-7618 Nazanin Rahmanian Anesthesiology Research Center, Department of Anesthesiology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran 0000-0001-9591-1795 Mohammad Dodangeh Balakhani Department of Pulmonology, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran Journal Article 2025 10 20 Background and Purpose: Recent advancements in biomedical science have introduced advanced triazole agents for the targeted treatment of pulmonary diseases, including various respiratory fungal infections. Opelconazole (PC945) is an innovative triazole-based antifungal compound that functions as a potent inhibitor of the CYP51 enzyme. It is strategically engineered for inhalation administration to achieve elevated local concentrations within the lungs while minimizing systemic exposure. In vitro studies have demonstrated the exceptional antifungal potency of opelconazole against various fungal strains, including antifungal drug-resistant fungal species. Furthermore, in vivo experiments using murine models of invasive pulmonary aspergillosis and candidiasis have revealed the superior efficacy of inhaled opelconazole, compared to conventional systemic antifungal therapies. Materials and Methods: A systematic search was conducted in ScienceDirect, ClinicalTrials.gov, PubMed, and Scopus for studies published up to May 2025 using the terms "opelconazole" OR "PC945" OR "Pulmocide" OR "inhaled opelconazole". Inclusion criteria were studies reporting on opelconazole for human pulmonary fungal infections with clinical or mycological outcomes. Study selection, data extraction, and synthesis were conducted in accordance with the PRISMA guidelines. Results: Among 141 identified records, 10 studies met the inclusion criteria. Most studies focused on invasive aspergillosis. Based on the findings, inhaled opelconazole demonstrated favorable efficacy, reducing fungal burden and improving clinical outcomes, with a generally good safety profile and minimal adverse events. Conclusion: Inhaled opelconazole is a promising, well-tolerated option for pulmonary fungal infections, including those resistant to conventional therapy. According to the study results, this agent could be an effective treatment option for patients who do not respond to or cannot tolerate other treatments. However, larger randomized controlled trials are needed to confirm these results.

https://cmm.mazums.ac.ir/article_150776_0dec03f914cbc2cbbb1d3ff30081dcb6.pdf

Mazandaran University of Medical Sciences Current Medical Mycology 2423-3439 12 Continuous 2026 02 01 Evaluation of MucorGenius® Real-Time PCR Assay for Mucormycosis Diagnosis: A Comparative Analysis 1665 1665 10.22034/cmm.2026.345408.1665 EN Kanchan Ajbani Department of Microbiology, P D Hinduja hospital and Medical Research Centre, Mumbai, India. 0009-0008-7314-5805 Siddhant Shetty Department of Microbiology, P D Hinduja hospital and Medical Research Centre, Mumbai, India. Saleha Chaudhry Department of Microbiology, P D Hinduja hospital and Medical Research Centre, Mumbai, India. 0009-0004-0556-2552 Ekta Tatkare Department of Microbiology, P D Hinduja hospital and Medical Research Centre, Mumbai, India. Harshala Gaonkar Department of Microbiology, P D Hinduja hospital and Medical Research Centre, Mumbai, India. 0009-0008-2277-6199 Shaoli Basu Department of Microbiology, P D Hinduja hospital and Medical Research Centre, Mumbai, India. 0000-0002-3800-6200 Camilla Rodrigues Department of Microbiology, P D Hinduja hospital and Medical Research Centre, Mumbai, India. 0000-0002-6105-6660 Anjali Shetty Department of Microbiology, P D Hinduja hospital and Medical Research Centre, Mumbai, India. Journal Article 2025 04 23 Background and Purpose: Mucormycosis, a formidable invasive fungal infection linked to Mucorales fungi, poses a significant threat to individuals. Rapid initiation of suitable antifungal therapy within five days of diagnosis has shown a noteworthy reduction in mortality rates, emphasizing the critical importance of timely identification. However, the diagnostic landscape is marred by the limited sensitivity of routine tools, including direct examination, histology, and culture. In this context, this study aimed to scrutinize the diagnostic performance of the commercially available pan-mucorales real-time polymerase chain reaction (PCR) assay, MucorGenius® (Pathonostics), on both pulmonary and extra-pulmonary specimens. Its efficacy was compared with that of conventional mycology methods to address the pressing need for more accurate and timely mucormycosis diagnosis. Materials and Methods: In total, 27 clinical specimens were included in the study, 17 of which were obtained from patients clinically suspected to have invasive mucormycosis. The remaining 10 specimens were from patients with microbiologically confirmed pulmonary tuberculosis, who had no evidence of fungal infection; these served as non-fungal controls and were included specifically to assess assay specificity. The DNA extraction from all samples was performed using the Qiagen DNA minikit, and real-time PCR was conducted with the MucorGenius® kit, targeting Rhizomucor spp., Lichtheimia spp., and Mucor/Rhizopus spp. Results: Of the 27 clinical cases, 17 were classified as either proven or probable mucormycosis based on EORTC/MSGERC criteria. The MucorGenius® PCR assay demonstrated an overall sensitivity of 76.47% and a specificity of 100% for detecting mucormycosis. Conclusion: The MucorGenius® Real-Time PCR assay exhibited promising diagnostic performance for mucormycosis, particularly in cases eluding conventional methods. Its sensitivity and specificity make it a valuable tool for early diagnosis, aiding clinical intervention in patients with a high index of suspicion.

https://cmm.mazums.ac.ir/article_150778_8646c48a45fc958d20550a893b2e835d.pdf