TY - JOUR
T1 - Fatal cokeromyces recurvatus pneumonia
T2 - Report of a case highlighting the potential for histopathologic misdiagnosis as coccidioides
AU - Ryan, Lori J.
AU - Ferrieri, Patricia
AU - Powell, Ralph D.
AU - Paddock, Christopher D.
AU - Zaki, Sherif R.
AU - Pambuccian, Stefan E.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2011/6
Y1 - 2011/6
N2 - Cokeromyces recurvatus is a dimorphic zygomycete with histologic morphology similar to Coccidioides immitis. A 66-year-old man who was status-post bone marrow transplantation for chronic myelogenous leukemia was hospitalized with new onset rash, nausea, and vomiting and subsequently expired. A sputum culture collected on the day of death revealed heavy growth of C. recurvatus 6 days after collection. At autopsy, microscopic examination of the lungs revealed numerous thick-walled, nonbudding spherules ranging in size from 40 to 80 μm. Initial immunohistochemical staining of the formalin-fixed lung tissue was positive for Coccidioides. Additional immunoperoxidase staining revealed the organisms were consistent with a zygomycete fungus, compatible with C. recurvatus infection. Polymerase chain reaction using panfungal primers was attempted on the formalin-fixed tissue but was inconclusive. This case highlights the potential for misdiagnosing Cokeromyces as Coccidioides when the diagnosis is based on histology and immunohistochemical staining.
AB - Cokeromyces recurvatus is a dimorphic zygomycete with histologic morphology similar to Coccidioides immitis. A 66-year-old man who was status-post bone marrow transplantation for chronic myelogenous leukemia was hospitalized with new onset rash, nausea, and vomiting and subsequently expired. A sputum culture collected on the day of death revealed heavy growth of C. recurvatus 6 days after collection. At autopsy, microscopic examination of the lungs revealed numerous thick-walled, nonbudding spherules ranging in size from 40 to 80 μm. Initial immunohistochemical staining of the formalin-fixed lung tissue was positive for Coccidioides. Additional immunoperoxidase staining revealed the organisms were consistent with a zygomycete fungus, compatible with C. recurvatus infection. Polymerase chain reaction using panfungal primers was attempted on the formalin-fixed tissue but was inconclusive. This case highlights the potential for misdiagnosing Cokeromyces as Coccidioides when the diagnosis is based on histology and immunohistochemical staining.
KW - Coccidioides immitis
KW - Cokeromyces recurvatus pneumonia
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U2 - 10.1177/1066896908330483
DO - 10.1177/1066896908330483
M3 - Article
C2 - 19147507
AN - SCOPUS:79955071285
SN - 1066-8969
VL - 19
SP - 373
EP - 376
JO - International Journal of Surgical Pathology
JF - International Journal of Surgical Pathology
IS - 3
ER -