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Journal of Clinical Microbiology, January 1999, p. 195-198, Vol. 37, No. 1
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

Sanjay G. Revankar,1,* Deanna A. Sutton,1 Stephen E. Sanche,1 Jyothi Rao,2 Marcus Zervos,2 Farnaz Dashti,2 and Michael G. Rinaldi1

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.


* 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.


Journal of Clinical Microbiology, January 1999, p. 195-198, Vol. 37, No. 1
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.



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