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Journal of Clinical Microbiology, January 1999, p. 195-198, Vol. 37, No. 1
University of Texas Health Science Center at
San Antonio, San Antonio, Texas,1 and
William Beaumont Hospital, Royal Oak,
Michigan2
Received 3 August 1998/Returned for modification 31 August
1998/Accepted 25 September 1998
Metarrhizium anisopliae is a common pathogen of insects
and has even been used to control insect populations. It is rarely isolated from human or animal sources, but recently, there have been
three reported cases of disease, two in humans and one in a cat. We
present our experience with five isolates from human sources, including
two that were the apparent causes of two cases of sinusitis in
immunocompetent hosts. The first patient was a 36-year-old male with
frontal and ethmoid sinusitis, and the second was a 79-year-old female
with chronic sinusitis. Both patients underwent surgery, and pathology
of the surgical specimens revealed branching hyphae. Cultures grew only
Metarrhizium species. Neither patient received antifungal
therapy, and both did well postoperatively. The other three isolates
were cultured from bronchoalveolar lavage specimens but were not felt
to be clinically significant. Antifungal susceptibility testing using
the National Committee for Clinical Laboratory Standards macrobroth
method revealed that all isolates were resistant to amphotericin B,
5-flucytosine, and fluconazole. Itraconazole and newer azole compounds
were more active. Metarrhizium species may cause disease in
humans, even those without evidence of immunosuppression, and are
apparently highly resistant to amphotericin B in vitro.
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Metarrhizium anisopliae as a Cause of Sinusitis in
Immunocompetent Hosts
*
Corresponding author. Mailing address:
Department of Pathology, 7703 Floyd Curl Dr., San Antonio, TX 78284. Phone: (210) 567-4131. Fax: (210) 567-4076. E-mail:
revankar{at}uthscsa.edu.
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