Rhino-orbital Mucormycosis presenting as facial cellulitis in a patient with high-risk acute myeloid leukemia in relapse

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Debureaux, Pierre-Edouard | Paccoud, Olivier | Guitard, Juliette | Baujat, Bertrand | Ruggeri, Annalisa | Battipaglia, Giorgia | Duléry, Rémy | Giannotti, Federica | Malard, Florent | Mohty, Mohamad | Brissot, Eolia

Edité par CCSD ; Elsevier-Masson SAS -

International audience. Abstract Aspergillus fumigatus is an environmental filamentous fungus that may act as an opportunistic pathogen causing a variety of diseases, including asthma or allergic bronchopulmonary aspergillosis, and infection, ranging from asymptomatic colonization to invasive pulmonary form, especially in immunocompromised patients. This fungus is characterized by different morphotypes including conidia which are the infective propagules able to germinate into hyphae. Due to their small size (2–3 µm), conidia released in the air can reach the lower respiratory tract. The objective of this study was to characterize the interactions between conidia and bronchial epithelial cells. To this end, we studied the role of bronchial epithelial cells, i . e ., the BEAS-2B cell line and human primary cells, in conidial germination of a laboratory strain and three clinical strains of A . fumigatus . Microscopic observations and galactomannan measurements demonstrated that contact between epithelial cells and conidia leads to the inhibition of conidia germination. We demonstrated that this fungistatic process is not associated with the release of any soluble components nor internalization by the epithelial cells. We highlight that this antifungal process involves the phosphoinositide 3-kinase pathway on the host cellular side and the lectin FleA on the fungal side. Collectively, our results show that bronchial epithelial cells attenuate fungal virulence by inhibiting germination of extracellular conidia, thus preventing the morphological change from conidia to filaments, which is responsible for tissue invasion.

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