Mazandaran University of Medical SciencesCurrent Medical Mycology2423-34396120200301Efficiency of vanillin in impeding metabolic adaptability and virulence of Candida albicans by inhibiting glyoxylate cycle, morphogenesis, and biofilm formation1810232410.18502/cmm.6.1.2501ENVenkataSaibabuAmity Institute of Biotechnology, Amity University Haryana, Gurugram, IndiaDepartment of Biosciences, Jamia Millia Islamia, New Delhi, IndiaZeeshanFatimaAmity Institute of Biotechnology, Amity University Haryana, Gurugram, IndiaKamalAhmadDepartment of Pharmaceutical Chemistry, Jamia Hamdard, New Delhi, IndiaLuqmanKhanDDepartment of Biosciences, Jamia Millia Islamia, New Delhi, IndiaSaifHameedAmity Institute of Biotechnology, Amity University Haryana, Gurugram, IndiaJournal Article20190808<strong>Background and Purpose:</strong> Candida albicans is the fourth most common cause of nosocomial fungal infections across the world. The current drug regimens are suffering from such drawbacks as drug resistance, toxicity, and costliness; accordingly, they highlight the need for the discovery of novel drug agents. The metabolic adaptability under low-carbon conditions and expression of functional virulence traits mark the success of pathogens to cause infection. The metabolic pathways, such as glyoxylate cycle (GC), enable C. albicans to survive under glucose-deficient conditions prevalent in the hostile niche. Therefore, the key enzymes, namely isocitrate lyase (ICL) and malate synthase (MLS), represent attractive agents against C. albicans. Similarly, virulence traits, such as morphogenesis and biofilm formation, are the crucial determinants of C. albicans pathogenicity. Regarding this, the present study was conducted to uncover the role of vanillin (Van), a natural food flavoring agent, in inhibiting GC, yeast-to-hyphal transition, and biofilm formation in human fungal pathogen C. albicans.<br /> <strong>Materials and Methods:</strong> For the determination of hypersensitivity under low-glucose conditions, phenotypic susceptibility assay was utilized. In addition, enzyme activities were estimated based on crude extracts while in-silico binding was confirmed by molecular docking. The assessment of morphogenesis was accomplished using hyphalinducing media, and biofilm formation was estimated using calcofluor staining, MTT assay, and biomass measurement. Additionally, the in vivo efficacy of Van was demonstrated using Caenorhabditis elegans nematode model.<br /> <strong> Results:</strong> Based on the results, Van was found to be a potent GC inhibitor that phenocopied ICL1 deletion mutant and displayed hypersensitivity under low-carbon conditions. Accordingly, Van facilitated the inhibition of ICL and MLS activities in vitro. Molecular docking analyses revealed the in-silico binding affinity of Van with Icl1p and Mls1p. Those analyses were also confirmative of the binding of Van to the active sites of both proteins with better binding energy in comparison to their known inhibitors. Furthermore, Van led to the attenuation of such virulence traits as morphogenesis, biofilm formation, and cell adherence. Finally, the antifungal efficacy of Van was demonstrated by the enhanced survival of C. elegans with Candida infection. The results also confirmed negligible hemolytic activity on erythrocytes.<br /> <strong>Conclusion:</strong> As the findings of the present study indicated, Van is a persuasive natural compound that warrants further attention to exploit its anticandidal potentialMazandaran University of Medical SciencesCurrent Medical Mycology2423-34396120200301Antifungal activity of eugenol on Cryptococcus neoformans biological activity and Cxt1p gene expression91410319610.18502/cmm.6.1.2502ENParvizHassanpourDepartment of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranMasoomehShams-GhahfarokhiDepartment of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran0000-0003-2562-965XMehdiRazzaghi-AbyanehDepartment of Mycology, Pasteur Institute of Iran, Tehran, IranJournal Article20190903<strong>Background and Purpose:</strong> The present study was targeted toward investigating the effects of eugenol on Cryptococcus neoformans biological activity and Cxt1p gene expression.<br /> <strong>Materials and Methods:</strong> For the purpose of the study, the growth, urease, synergism activity, and disk diffusion of C. neoformans were assessed in eugenol-treated culture. The minimum inhibitory concentration (MIC) was determined by the Clinical and Laboratory Standards Institute M27-A3 method at a concentration range of 0.062-2 mg/mL. Subsequently, the expression of Cxt1p genes was studied at the MIC50 concentration of eugenol using real-time polymerase chain reaction.<br /> <strong>Results:</strong> The obtained results showed that eugenol at the concentrations of 125 and 500 μg/mL resulted in 50% and 100% growth inhibition in C. neoformans, respectively. In terms of urease activity, the results showed that the addition of MIC50 of eugenol and fluconazole to urea medium reduced urease activity in C. neoformans. In the culture treated with eugenol, the inhibition zone of antifungal drugs, namely amphotericin B, itraconazole, and fluconazole, was increased to 36±0.002, 22±0.001, and 12±0.002 mm, respectively. The expression levels of Cxt1p in the eugenol-treated, fluconazole-treated, and non-treated samples were estimated at 46%, 58%, and 100%, respectively.<br /> <strong>Conclusion:</strong> The findings of the current study revealed that eugenol could cause C. neoformans growth inhibition and reduce Cxt1p expression in this species. As the results indicated, the susceptibility of C. neoformans to fluconazole was increased when combined with eugenol.<br /> <strong> </strong>Mazandaran University of Medical SciencesCurrent Medical Mycology2423-34396120200301Translation elongation factor 1-alpha gene as a marker for diagnosing of candidal onychomycosis152110288610.18502/cmm.6.1.2503ENKeyvanPakshirDepartment of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranBasic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, IranForoughFarazmandDepartment of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranFarnoushGhasemiDepartment of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranHosseinMirhendiDepartment of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-1006-4169KamiarZomorodianDepartment of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranBasic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, IranMahboobehKharaziDepartment of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranRamtinAlborzi PourMedical mycology laboratory, Razi hospital, Tehran, IranHajarGolestaniDepartment of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranMarjanMotamediDepartment of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical0000-0003-1066-8752Journal Article20190905<strong>Background and Purpose:</strong> Culture-based identification methods have been the gold standard for the diagnosis of candidal onychomycosis. Molecular technologies, such as polymerase chain reaction (PCR) assays, can provide an alternative for the rapid detection of Candida species. The present study was conducted to investigate a pan-Candida PCR assay based on the translation elongation factor 1-alpha (TEF-1α) gene for the detection of the most prevalent pathogenic Candida species.<br /> <strong>Materials and Methods:</strong> For the purpose of the study, an optimized pan-Candida PCR primer pair was designed, and the target was amplified and sequenced. The analytical and clinical diagnostic performance of the designed primers was tested using 17 reference strains, 137 nail scrapings suspected of onychomycosis, and 10 healthy nail specimens.<br /> <strong>Results:</strong> The use of the universal pan-Candida primers designed on TEF-1α gene resulted in the successful amplification of a 270-base pair fragment in all Candida species tested, except for C. glabrata, and reacted neither with other fungi nor with E. coli. The sequence difference count matrix showed poor insertion/deletion differences (0-2 nt) among Candida species. Among 137 nail specimens, 35% (n=48), 30.7% (n=42), and 40.1% (n=55) of the samples were found to be positive by direct microscopy, culture, and pan-Candida PCR, respectively.<br /> <strong>Conclusion:</strong> Based on the findings, the PCR-based detection targeting the DNA TEF-1α gene is a rapid and simple procedure for the diagnosis of candidal onychomycosis directly from nail sample.Mazandaran University of Medical SciencesCurrent Medical Mycology2423-34396120200301Toxigenicity and phylogeny of Aspergillus section Flavi in poultry feed in Iran222910380910.18502/cmm.6.1.2504ENSeyed SoheilGhaemmaghamiFeed Hygienist, Institute of Agricultural Education and Extension, Agricultural Research, Education and Extension Organization (AREEO), Tehran, Iran0000-0002-5413-0391NasrinPashootanDepartment of Mycology, Pasteur Institute of Iran, Tehran, IranMehdiRazzaghi-AbyanehDepartment of Mycology, Pasteur Institute of Iran, Tehran, IranJournal Article20191002<strong>Background and Purpose:</strong> This study was conducted to evaluate the presence of aflatoxigenic strains and level of aflatoxin in poultry feed. Aflatoxigenic strains were investigated in corn and soybean meal as the ingredients of poultry feed, as well as in two types of commercial feed, namely pellet and mash. The gene sequencing was performed to identify the species of Aspergillus section Flavi.<br /> <strong>Materials and Methods:</strong> All samples were randomly collected from feed storage silos located in Iran in 2018. The samples were cultured on specialized media for 2 weeks at 28ºC. Identification of Aspergillus section Flavi isolates was based on macro- and microscopic morphological criteria and molecular analysis. The thin-layer chromatography (TLC) was applied to confirm the aflatoxigenic isolates. In addition, the level of aflatoxin B1 (AFB1) produced by these isolates was determined by high-performance liquid chromatography. The strains were subjected to sequence analysis, and Bt2 PCR products were purified by the QIAquick PCR purification kit. At the final stage, the phylogenetic tree was built.<br /> <strong>Results:</strong> Among 54 isolates identified as Aspergillus section Flavi, 20 (37%) isolates were found to produce aflatoxin at a range of 11.28±1.18 to 2239.92±92.26 μg/g fungal dry weight. The aflatoxigenic isolates had the frequencies of 45%, 40%, 10%, and 5% in the corn, pellet, soybean meal, and mash samples, respectively. Furthermore, the mean concentrations of AFB1 were significantly higher in the corn samples (707.04±39.05) than that of other poultry feed samples (p <0.05). A total of 34 (63%) isolates were detected as non-aflatoxigenic on the yeast extract-sucrose broth in TLC analysis. The toxigenic isolates produced the highest (2232.62±55.49) and lowest (11.28±1.18) levels of AFB1 in the corn samples, compared to other feedstuffs. Furthermore, the mean level of AFB1 in mash product was 554.09±10.36 μg/g, compared to a mean level of 229.22±11.09 μg/g in pellets. The isolates were randomly selected, sequenced, and then analyzed. Subsequently, the phylogenetic tree of Aspergillus section Flavi was plotted.<br /> <strong>Conclusion:</strong> The process of converting raw ingredients to compound poultry feed is more hazardous when there is not enough time and temperature provided to eliminate aflatoxigenic isolates. Therefore, Aspergillus section Flavi in poultry feed can pose a threat to the poultry industry and poultry products, thereby affecting the health status of humans. Unprocessed/processed materials, such as corns and pelleted feed, need further monitoring, especially when conditions are not optimal for destroying the fungus.Mazandaran University of Medical SciencesCurrent Medical Mycology2423-34396120200301Molecular characterization of fungi causing colonization and infection in organ transplant recipients: A one-year prospective study303510580410.18502/cmm.6.1.2505ENFereshtehZareiDepartment of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, IranJamalHashemiDepartment of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, IranFood Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran0000-0002-1834-6822MohamadrezaSalehiDepartment of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran0000-0002-1987-5929ShahramMahmoudiDepartment of Medical Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran0000-0003-0421-8659EnsiehZibafarDepartment of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, IranZahraAhmadinejadLiver Transplantation Research Center, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IranAbbasRahimi ForoushaniDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IranPegahArdiDepartment of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, IranRoshanakDaie GhazviniDepartment of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran0000-0001-5320-5323Journal Article20191007<strong>Background and Purpose:</strong> Organ transplant recipients are vulnerable to fungal infections. The aim of this study was to determine the prevalence of fungal colonization and infections among patients who underwent various transplantations and molecularly characterize the etiological agents.<br /> <strong>Materials and Methods:</strong> This study was conducted on candidates for transplantation in Imam Khomeini Hospital, Tehran, Iran, from April 2017 to April 2018. All patients were monitored for fungal colonization or infections before and after transplantation. Isolated fungi were identified using molecular methods.<br /> <strong>Results:</strong> A total of 125 patients, including 86 males and 39 females, with the mean age of 52.2 years participated in the study (age range: 15-75 years). Out of 125 patients, 84 (67.2%) cases had fungal colonization that appeared pre- and post-transplantation in 21 and 63 cases, respectively (alone or concurrent with another infection in 55 and 29 cases, respectively). In addition, a total of 39 episodes of fungal infections were diagnosed in 36 (28.8%) recipients (alone or concurrent with colonization in 7 and 29 cases, respectively). Out of the 39 fungal infections, 9 cases appeared pre-transplantation, while the other 30 cases occurred post-transplantation. However, no fungal colonization or infection was observed in 34 (27.2%) patients. Oral candidiasis (n=20) was the most common type of infection, followed by funguria (n=7), onychomycosis (n=5), candidemia (n=3), rhinocerebral mucormycosis (n=1), cutaneous mucormycosis (n=1), cutaneous aspergillosis (n=1), and peritonitis (n=1). Six yeast species were recovered from colonization cases with the dominance of Candida albicans both before and after transplantation. The observed fungal infections were caused by 11 distinct species, including the members of Candida (i.e., C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, and C. krusei), Aspergillus (i.e., A. oryzae and A. candidus), Rhizopus (i.e., R. oryzae and R. microsporus), Trichosporon asahii, and Trichophyton interdigitale. The results also indicated that the development of a fungal infection post-transplantation was associated with fungal colonization (r=0.0184; P=0.043).<br /> <strong>Conclusion:</strong> Based on the results, fungal colonization was a common finding in transplant recipients at Imam Khomeini Hospital. However, the incidence of fungal infections was comparable with those of other centers. As the oral cavity was the most common site of colonization and infection, it might be beneficial to take further care about the oral health of patients using effective mouthwash.Mazandaran University of Medical SciencesCurrent Medical Mycology2423-34396120200301Low in vitro activity of sertaconazole against clinical isolates of dermatophyte364110151010.18502/cmm.6.1.2507ENMahsaBehnamDepartment of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranHosseinZarrinfarAllergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-1449-4668Mohammad JavadNajafzadehDepartment of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranAliNaseriDepartment of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranLidaJarahiDepartment of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMonikaNovak BabičDepartment of Biology, Biotechnical Faculty, University of Ljubljana, Ljubljana, SloveniaJournal Article20191017<strong>Background and Purpose:</strong> Dermatophytes are a group of fungi specialized in invading humans and other vertebrate keratinized tissues. These fungi cause a variety of skin, nail, and hair disorders, called dermatophytosis (tinea). In some cases, drug resistance to antifungals necessitates special treatment. Among the antifungal agents, sertaconazole (i.e., a third-generation imidazole) has a broad-spectrum against dermatophyte species. Regarding this, the present study was conducted to investigate the antifungal susceptibility of dermatophytes obtained from patients with dermatophytosis in Mashhad located in northeastern Iran.<br /> <strong>Materials and Methods:</strong> A total of 75 clinical dermatophyte isolates, including Trichophyton mentagrophytes (n=21), T. interdigitale (n=18), T. tonsurans (n=16), Epidermophyton floccosum (n=11), Microsporum canis (n=5), Nannizzia fulvum (n=2), T. benhamiae (n=1), and T. verrucosum (n=1), were evaluated against five antifungal agents of sertaconazole, itraconazole, clotrimazole, terbinafine, and griseofulvin based on the CLSI M38-A2 guideline.<br /> <strong>Results:</strong> According to the results, the minimum inhibitory concentration (MIC) ranges of sertaconazole, terbinafine, griseofulvin, itraconazole, and clotrimazole were estimated at 0.125-16, 0.002-1, 0.5-4, 0.031-4, and 0.016-4 μg/ml, respectively, for dermatophyte species. In addition, the geometric mean (GM) values of the MIC of sertaconazole, terbinafine, griseofulvin, itraconazole, and clotrimazole were obtained as 3.39, 1, 1.44, 1.52, and 1.93, respectively.<br /> <strong>Conclusion:</strong> Among the tested antifungals, terbinafine and griseofulvin were the most effective agents against dermatophyte isolates. However, sertaconazole, a third-generation imidazole, did not show any significant effect. Furthermore, M. canis and E. floccosum showed the best response to the antifungal agents.<br /> <strong> </strong>Mazandaran University of Medical SciencesCurrent Medical Mycology2423-34396120200301Ultrastructure of hyphal cells of Trichophyton tonsurans424610151110.18502/cmm.6.1.2508ENAmaliyaStepanovaNorth-Western State Medical University named after I.I. Mechnikov: Kashkin Research Institute of Medical Mycology, Saint Petersburg, Russiahttps://orcid.org/0000-0003-0739-4586SybrenDe HoogWesterdijk Fungal Biodiversity Institute, Utrecht, The NetherlandsCentre of Expertise in Mycology of Radboud University Medical Centre / Canisius Wilhelmina Hospital, Nijmegen, The Netherlands0000-0002-5344-257XNataliyaVasilyevaNorth-Western State Medical University named after I.I. Mechnikov: Kashkin Research Institute of Medical Mycology, Saint Petersburg, Russia0000-0003-3693-5468KonstantinRaznatovskiyDepartment of Dermatovenerology, North-Western State Medical University I.I. Mechnikov, St. Petersburg, Russia0000-0003-1022-7463GalinaChilinaNorth-Western State Medical University named after I.I. Mechnikov: Kashkin Research Institute of Medical Mycology, Saint Petersburg, RussiaJournal Article20191021<strong>Background and Purpose:</strong> Trichophyton tonsurans is a widely distributed anthropophilic dermatophyte causing different diseases of skin. In the literature limited data are available about the morphogenesis of vegetative mycelium of T. tonsurans and related anthropophilic dermatophytes. The aim of present study was to describe ultrastructural patterns of development, cellular organellography and septal pore apparatus structure of in vitro growing vegetative mycelium of T. tonsurans.<br /> <strong>Materials and Methods:</strong> Trichophyton tonsurans strain RCPFF 214/898 was grown on solid Czapek’s Agar (CzA) at 28ºС. For investigation of colonies morphology we used methods of light-, scanning and transmission electron microscopy (SEM and TEM).<br /> <strong>Results:</strong> Differences in morphogenesis of aerial and substrate hyphae were revealed. Mitochondrial reticulum and fibrosinous bodies were shown in T. tonsurans for the first time. The septal pore apparatus in hyphal cells of was comprised Woronin bodies and septal pore plugs. Woronin bodies (0.18 μm), located with 1‒4 near the pore, were spherical, membrane-bound, and had a homogeneous, electron-dense content. The cells of aerial and submerged hyphal cells of T. tonsurans contain two nuclei.<br /> <strong>Conclusion:</strong> Mature cells of substrate hyphae appeared more active than comparable cells in the aerial mycelium. During the maturation process, the differences in number and morphology of mitochondria, number of vacuoles, and in the synthesis of different types of storage substances were revealed. Presence of “mitochondrial reticulum” and variable types of storage substances in submerged hyphal cells suggested higher levels of metabolic activity compared to aerial mycelium.<br /> <strong> </strong>Mazandaran University of Medical SciencesCurrent Medical Mycology2423-34396120200301Candida auris emergence in the Himalayan foothills: First case report from Uttarakhand, India475010150810.18502/cmm.6.1.2509ENSuneetaMeenaDepartment of Microbiology, All India Institute of Medical Sciences, Rishikesh, India0000000329270840RanjanaRohillaDepartment of Microbiology, All India Institute of Medical Sciences, Rishikesh, India0000-0002-4851-6933NeelamKaisthaDepartment of Microbiology, All India Institute of Medical Sciences, Rishikesh, IndiaArpanaSinghDepartment of Microbiology, All India Institute of Medical Sciences, Rishikesh, IndiaPratimaGuptaDepartment of Microbiology, All India Institute of Medical Sciences, Rishikesh, IndiaJournal Article20190614<strong>Background and Purpose:</strong> Candida auris is a rapidly emerging fungus, which is considered globally a cause of concern for public health. This report describes the first case of C. auris fungemia from a tertiary care hospital in the hilly state of Uttarakhand in India. Case report: The patient was a 37-year-old female who underwent a Whipple procedure for the carcinoma of the head of the pancreas. She developed fever 12 days after the operation while recovering from surgery in the hospital. Blood culture yielded C. auris which was identified by the matrix-assisted laser desorption/ionization-time of flight mass spectrometry (Bruker Daltonics, Germany). The patient was successfully treated with caspofungin. Conclusion: In conclusion, C. auris is potentially multidrug resistant, resulting in nosocomial outbreaks and sporadic infections which can be potentially prevented when identified early by implementing contact precautionsBackground and Purpose: Candida auris is a rapidly emerging fungus, which is considered globally a cause of concern for public health. This report describes the first case of C. auris fungemia from a tertiary care hospital in the hilly state of Uttarakhand in India.<br /> <strong>Case report:</strong> The patient was a 37-year-old female who underwent a Whipple procedure for the carcinoma of the head of the pancreas. She developed fever 12 days after the operation while recovering from surgery in the hospital. Blood culture yielded C. auris which was identified by the matrix-assisted laser desorption/ionization-time of flight mass spectrometry (Bruker Daltonics, Germany). The patient was successfully treated with caspofungin.<br /> <strong>Conclusion:</strong> In conclusion, C. auris is potentially multidrug resistant, resulting in nosocomial outbreaks and sporadic infections which can be potentially prevented when identified early by implementing contact precautions.Mazandaran University of Medical SciencesCurrent Medical Mycology2423-34396120200301Curvularia lunata causing orbital cellulitis in a diabetic patient: An old fungus in a new territory515410150910.18502/cmm.6.1.2510ENHimanshuNarulaDepartment of Microbiology, All India Institute of Medical Sciences, Rishikesh0000-0003-1658-797XSuneetaMeenaDepartment of Microbiology, All India Institute of Medical Sciences, Rishikesh0000000329270840SwetaJhaDepartment of Microbiology, All India Institute of Medical Sciences, RishikeshNeelamKaisthaDepartment of Microbiology, All India Institute of Medical Sciences, RishikeshMonikaPathaniaDepartment of Medicine, All India Institute of Medical Sciences, RishikeshPratimaGuptaDepartment of Microbiology, All India Institute of Medical Sciences, RishikeshJournal Article20190626<strong>Background and Purpose:</strong> Rhinocerebral mycosis is a rapidly invasive infection in diabetic patients with an unfavorable course. Herein, we report a rare case of orbital cellulitis caused by Curvularia lunata following fungal rhinosinusitis in a diabetic male patient.<br /> <strong>Case report:</strong> A 35-year-old male with uncontrolled diabetes presented to the emergency department of our center with high-grade fever accompanied by chills and rigors, severe diffuse headache, and projectile vomiting with swelling and loss of vision in the right eye. The tissue sample from surgical debridement showed pigmented hyphae; in addition, Curvularia lunata was isolated in culture. Imaging was indicative of orbital extension. Therefore, the patient was diagnosed with fungal rhinosinusitis with orbital cellulitis. The patient was subjected to extensive surgical debridement, along with antifungals. Rhinosinusitis resolved; however, the loss of vision was irreversible.<br /> <strong>Conclusion:</strong> Orbital cellulitis is a very rare but life-threatening complication of fungal rhinosinusitis. Very few cases of orbital cellulitis following fungal rhinosinusitis have been reported in the literature. Early and prompt diagnosis can save the life of a patient.<br /> <strong> </strong>Mazandaran University of Medical SciencesCurrent Medical Mycology2423-34396120200301The first rare and fatal case of invasive aspergillosis of spinal cord due to Aspergillus nidulans in an Iranian child with chronic granulomatosis disease: review of literature556010232510.18502/cmm.6.1.2551ENMahinTavakoliStudent Research Committee, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran0000-0003-3376-7059Mohammad T.HedayatiInvasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran0000-0001-6415-4648HosseinMirhendiDepartment of Medical Mycology and Parasitology, Isfahan University of Medical Sciences, Isfahan, IranSadeghNooripoor-SisakhtCellular and Molecular Research center, Yasuj University of Medical Sciences, Yasuj, IranNewshaHedayatiStudent Research Committee, Invasive Fungi Research Center, Sari, IranFatemehSaghafiDepartment of Clinical pharmacy, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran0000-0002-4185-1341SetarehMamishiDepartment of Infectious Diseases, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iranhttps://orcid.org/0000-0003-4735-3885Journal Article20190930<strong>Background and Purpose:</strong> Invasive aspergillosis (IA) of the central nervous system (CNS) is a devastating complication which is rarely reported in immunocompromised children.<br /> In this case presentation, we reported a rare and fatal IA with spinal cord involvement in a 10-year-old child with X-linked chronic granulomatosis disease (CGD).<br /> <strong>Case report:</strong> The child had a previous history of pulmonary tuberculosis. A cervical spine X-ray revealed the involvement of cervical vertebrae (T4/T5) and ribs causing spinal cord compression and epidural abscess. The patient underwent a decompressive laminectomy and mass removal. The histopathology and culture results suggested IA. Despite the aggressive and prolonged therapy, he died within one year. Aspergillus nidulans was identified as the causative agent based on morphological and molecular studies.<br /> <strong>Conclusion:</strong> This synopsis represents the aggressive behavior of infection caused by A. nidulans in the CGD patient.