Featured Research

from universities, journals, and other organizations

Rare emerging disease claims Texas girl's leg: PCR plus sequencing identified culprit

Date:
April 16, 2012
Source:
American Society for Microbiology
Summary:
A 14-year-old Texas girl was finally cured of an oft-fatal emerging disease when doctors amputed her lower leg, where the infection arose, after various antimicrobials proved ineffective. The culprit was Pythium insidiosum, a fungus-like microbe which rarely causes disease in humans and then primarily in Thailand.

A 14-year-old Texas girl was finally cured of an oft-fatal emerging disease when doctors amputed her lower leg, where the infection arose, after various antimicrobials proved ineffective. The culprit was Pythium insidiosum, a fungus-like microbe which rarely causes disease in humans and then primarily in Thailand. The case "clearly highlights the need for clinicians to have the best support possible from the clinical microbiology lab," says Don Murphey of Cook Children's Medical Center, who served as attending physician during the case. The case report is published in the April Journal of Clinical Microbiology.

The girl, otherwise healthy, presented to an urgent care facility with a 2-week history of a continuously enlarging erythematous bump on her lower leg, having reported recently swimming in an algae-filled pool. "Over the course of several weeks, what started as a very small lesion grew to involve most of her leg," says first author Stephen J. Salipante, of the University of Washington, Seattle. "Initial cultures of the wound suggested that this was a bacterial infection, and it was treated as such, but without success."

"She eventually needed to be hospitalized," says Salipante. Her treatment team at Cook Children's hospital tried increasingly aggressive medical and surgical management, including different antibiotic regimens, antifungals, and surgical debridements, but the infection simply didn't respond. "Given the microscopic appearance of the organism, our working hypothesis was that this was some kind of unusual, and very aggressive fungus," says Salipante.

However, sequencing a segment of DNA that is useful for categorizing fungi, the ITS1 sequence, "revealed that this was not a fungus at all -- rather, the DNA sequence very closely matched… P. insidiosum," says Salipante. This microbe has long been known to be a veterinary pathogen, primarily affecting horses and dogs, disfiguring them, often fatally. Only about 150 human cases have been reported in the literature -- nearly all of them in Thailand. "Needless to say, this was an unexpected result, as this young woman had not left Texas," says Salipante.

But "this organism did not demonstrate sensitivity in vitro to any of the antifungals or antimicrobials that had some activity for other isolates," says Murphey. Efforts at treatment even included trying an experimental therapeutic vaccine for Pythium-afflicted horses," says Murphey. "When it became clear to all of us that we were not going to clear the advancing local infection, we went on to amputation."

The amputation "undoubtedly saved this young woman's life," says Salipante. Now, nearly six months later, there is no vestige of infection.

"Pythiosis is believed to be an emerging human pathogen, meaning that the number of cases are expected to go up in the future," says Salipante.

"We have demonstrated that molecular identification by PCR screening and DNA sequencing provides a strategy to allow definitive identification of a range of pathogens, even unsuspected ones," says Salipante.

"DNA sequencing is a not just a tool for discovery anymore -- it provides critical data for making decisions impacting patient care," says coauthor Brad T. Cookson of the University of Washington. "I would add that medical care currently offers patients something very special -- our report demonstrates the vitality and utility of collaborative, transdisciplinary approaches for solving challenging medical problems."


Story Source:

The above story is based on materials provided by American Society for Microbiology. Note: Materials may be edited for content and length.


Journal Reference:

  1. S. J. Salipante, D. R. Hoogestraat, D. J. SenGupta, D. Murphey, K. Panayides, E. Hamilton, I. Castaneda-Sanchez, J. Kennedy, P. W. Monsaas, L. Mendoza, K. Stephens, J. J. Dunn, B. T. Cookson. Molecular Diagnosis of Subcutaneous Pythium insidiosum Infection by Use of PCR Screening and DNA Sequencing. Journal of Clinical Microbiology, 2011; 50 (4): 1480 DOI: 10.1128/JCM.06126-11

Cite This Page:

American Society for Microbiology. "Rare emerging disease claims Texas girl's leg: PCR plus sequencing identified culprit." ScienceDaily. ScienceDaily, 16 April 2012. <www.sciencedaily.com/releases/2012/04/120416150405.htm>.
American Society for Microbiology. (2012, April 16). Rare emerging disease claims Texas girl's leg: PCR plus sequencing identified culprit. ScienceDaily. Retrieved October 1, 2014 from www.sciencedaily.com/releases/2012/04/120416150405.htm
American Society for Microbiology. "Rare emerging disease claims Texas girl's leg: PCR plus sequencing identified culprit." ScienceDaily. www.sciencedaily.com/releases/2012/04/120416150405.htm (accessed October 1, 2014).

Share This



More Health & Medicine News

Wednesday, October 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Some Positive Ebola News: Outbreak 'Contained' In Nigeria

Some Positive Ebola News: Outbreak 'Contained' In Nigeria

Newsy (Sep. 30, 2014) The CDC says a new case of Ebola has not been reported in Nigeria for more than 21 days, leading to hopes the outbreak might be nearing its end. Video provided by Newsy
Powered by NewsLook.com
UN Ebola Mission Head: Immediate Action Is Crucial

UN Ebola Mission Head: Immediate Action Is Crucial

AFP (Sep. 30, 2014) The newly appointed head of the United Nations Mission for Ebola Emergency Response (UNMEER), Anthony Banbury, outlines operations to tackle the virus. Duration: 00:39 Video provided by AFP
Powered by NewsLook.com
CDC Confirms First Case of Ebola in US

CDC Confirms First Case of Ebola in US

AP (Sep. 30, 2014) The CDC has confirmed the first diagnosed case of Ebola in the United States. The patient is being treated at a Dallas hospital after traveling earlier this month from Liberia. (Sept. 30) Video provided by AP
Powered by NewsLook.com
New Breast Cancer Drug Extends Lives In Clinical Trial

New Breast Cancer Drug Extends Lives In Clinical Trial

Newsy (Sep. 30, 2014) In a clinical trial, breast cancer patients lived an average of 15 months longer when they received new drug Perjeta along with Herceptin. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins