Fungal Diseases

Other Pathogenic Fungi

Exserohilum rostratum

Exserohilum is a common mold found in soil and on plants, especially grasses, and thrives in warm and humid climates. Exserohilum rarely causes infections for people. The most common infections caused by Exserohilum are sinusitis and skin infections, but it can cause keratitis (eye inflammation), subcutaneous phaeohyphomycosis, endocarditis (inflammation of the lining of the heart), and osteomyelitis (bone infection).
Exserohilum rostratum has been recognized as a human pathogen.

People at Risk

Although anyone can get an infection with Exserohilum, infections most often occur in people with weak immune systems¹.

Injury is another cause of infection².

Investigation of Fungal Meningitis, October 2012

CDC Responds to Multistate Fungal Meningitis Outbreak

The Centers for Disease Control and Prevention (CDC) with state and local health departments and the Food and Drug Administration (FDA) are investigating a multistate fungal meningitis outbreak among patients who have received a steroid injection of a potentially contaminated product into the spinal area. Several patients suffered strokes that are believed to have resulted from their infection. The investigation also includes fungal infections associated with injections in a peripheral joint space, such as a knee, shoulder or ankle. CDC and public health officials are referring any patients who have symptoms that suggest possible meningitis or a possible peripheral joint infection to their physicians who can evaluate them further. Those patients injected in peripheral joints only are not believed to be at risk for fungal meningitis but could be at risk for joint infection.

Prevention

For people with weakened immune systems or severe lung diseases, there are steps that can be taken to help reduce exposure, including:

Wear an N95 mask when near or in a dusty environment such as construction sites
Avoid activities that involve close contact to soil or dust, such as yard work or gardening
Use air quality improvement measures such as HEPA filters
Take prophylactic antifungal medication if deemed necessary by your healthcare provider
Clean skin injuries well with soap and water, especially if the injury has been exposed to soil or dust

References

Case Reports

Aquino VM, Norvell JM, Krisher K, Mustafa MM. Fatal disseminated infection due to Exserohilum rostratum in a patient with aplastic anemia: case report and review. Clin Infect Dis 1995;20(1):176-178.
Bhigjee AI, Parmanand V, Hoosen AA, Roux L, Bill PL. Disseminated Exserohilum infection [case reports letter]. J Infect 1993;26(3):336-7.
Anandi V, George JA, Thomas R, Brahmadathan KN, John TJ. Phaeohyphomycosis of the eye caused by Exserohilum rostratum in India. Mycoses 1991;34(11-12):489-491.
Tieman JM, Furner BB. Phaeohyphomycosis caused by Exserohilum rostratum mimicking hemorrhagic herpes zoster. J Am Acad Dermatol 1991;25(5 Pt 1):852-854.
Burges GE, Walls CT, Maize JC. Subcutaneous phaeohyphomycosis caused by Exserohilum rostratum in an immunocompetent host. Arch Dermatol 1987;123(10):1346-1350.
Douer D, Goldschmied-Reouven A, Segev S, Ben-Bassat I. Human Exserohilum and Bipolaris infections: report of Exserohilum nasal infection in a neutropenic patient with acute leukemia and review of the literature. J Med Vet Mycol 1987;25(4):235-241.
McGinnis MR, Rinaldi MG, Winn RE. Emerging agents of phaeohyphomycosis: pathogenic species of Bipolaris and Exserohilum. J Clin Microbiol 1986;24(2):250-259.
Moneymaker CS, Shenep JL, Pearson TA, Field ML, Jenkins JJ. Primary cutaneous phaeohyphomycosis due to Exserohilum rostratum (Drechslera rostrata) in a child with leukemia. Pediatr Infect Dis 1986;5(3):380-382.
Padhye AA, Ajello L, Wieden MA, Steinbronn KK. Phaeohyphomycosis of the nasal sinuses caused by a new species of Exserohilum. J Clin Microbiol 1986;24(2):245-249.
Adam RD, Paquin ML, Petersen EA, Saubolle MA, Rinaldi MG, Corcoran JG, et al. Phaeohyphomycosis caused by the fungal genera Bipolaris and Exserohilum. A report of 9 cases and review of the literature. Medicine 1986;65(4):203-217.

Identification of Medically Important Molds

Mycology online [Internet]. Adelaide: The University of Adelaide; c2012 [updated 2012 Nov 11].
da Cunha KC, Sutton DA, Gené J, Capilla J, Cano J, Guarro J. Molecular identification and in vitro response to antifungal drugs of clinical isolates of Exserohilum. Antimicrob Agents Chemother 2012;56(9):4951-4954.
DoctorFungus.org [Internet]. The Official Website of the Mycoses Study Group; c2007 [updated 2007 Jan 27].

General Information

Revankar SG, Sutton DA. Melanized fungi in human disease. Clin Microbiol Rev 2010;23(4):884-928.
Adler A, Yaniv I, Samra Z, Yacobovich J, Fisher S, Avrahami G, et al. Exserohilum: an emerging human pathogen. Eur J Clin Microbiol Infect Dis 2006;25(4):247-253.
De Hoog GS, Guarro J, Gené J, Figueras MJ, editors. Atlas of clinical fungi. 2nd ed. Utrecht (Netherlands): Centraalbureau voor Schimmelkultures; 2000.
Sivanesan A. Graminicolous species of Bipolaris, Curvularia, Drechslera, Exserohilum and their teleomorphs. Wallingford (United Kingdom): C.A.B. International;1987.

Footnotes

¹ American Air Testing [Internet].

² Adler A, Yaniv I, Samra Z, Yacobovich J, Fisher S, Avrahami G, et al. Exserohilum: an emerging human pathogen. Eur J Clin Microbiol Infect Dis 2006;25(4):247-53.

Top of Page