First Reported Case of Cryptococcus gattii in the Southeastern USA Implications for Travel-Associated Acquisition of an Emerging Pathogen 英文参考文献.docVIP

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First Reported Case of Cryptococcus gattii in the Southeastern USA Implications for Travel-Associated Acquisition of an Emerging Pathogen 英文参考文献.doc

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First Reported Case of Cryptococcus gattii in the Southeastern USA Implications for Travel-Associated Acquisition of an Emerging Pathogen 英文参考文献

FirstReportedCaseofCryptococcusgattiiinthe SoutheasternUSA:ImplicationsforTravel-Associated AcquisitionofanEmergingPathogen EdmondJ.Byrnes,III1,WenjunLi1,YonathanLewit1,JohnR.Perfect2,DeeA.Carter3,GaryM.Cox2, JosephHeitman1,2 * 1DepartmentofMolecularGeneticsandMicrobiology,DukeUniversityMedicalCenter,Durham,NorthCarolina,UnitedStatesofAmerica, 2DepartmentofMedicine, Duke University Medical Center, Durham, North Carolina, United States of America, 3Department of Molecular and Microbial Biosciences, The University of Sydney, Sydney,NewSouthWales,Australia Abstract In 2007, the first confirmed case of Cryptococcus gattii was reported in the state of North Carolina, USA. An otherwise healthy HIV negative male patient presented with a large upper thigh cryptococcoma in February, which was surgically removedandthepatientwasstartedonlong-termhigh-dosefluconazoletreatment.InMayof2007,thepatientpresented totheDukeUniversityhospitalemergencyroomwithseizures.MagneticresonanceimagingrevealedtwolargeCNSlesions foundtobecryptococcomasbasedonbrainbiopsy.PriorchestCTimaginghadrevealedsmalllungnodulesindicatingthat C.gattiisporesordesiccatedyeastwerelikelyinhaledintothelungsanddisseminationoccurredtoboththelegandCNS. Thepatient’stravelhistoryincludedavisitthroughouttheSanFrancisco,CAregioninSeptemberthroughOctoberof2006, consistent with acquisition during this time period. Cultures from both the leg and brain biopsies were subjected to analysis.Basedonphenotypicandmolecularmethods,bothisolateswereC.gattii,VGImoleculartype,anddistinctfromthe VancouverIslandoutbreakisolates.Basedonmultilocussequencetypingofcodingandnoncodingregionsandvirulencein a heterologous host model, the leg and brain isolates are identical, but the two differed in mating fertility. Two clinical isolates,onefromatransplantrecipientinSanFranciscoandtheotherfromAustralia,wereidenticaltotheNorthCarolina clinicalisolateatallmarkerstested.Closelyrelatedisolatesthatdifferatonlyoneorafewnoncodingmarkersarepre