Date: 26 November 2013
Secondary metabolites, 3D structure: Trivial name – citreoviridin
Copyright: n/a
Notes:
Species: A. terreusSystematic name: D-Iditol, 2,5-anhydro-1,6-dideoxy-2-C-[(1E,3E,5E,7E)-8-(4-methoxy-5-methyl-2-oxo-2H-pyran-6-yl)-2-methyl-1,3,5,7-octatetraenyl]-4-C-methyl- (9CI)Molecular formulae: C23H30O6Molecular weight: 402.481Chemical abstracts number: 25425-12-1Selected references: Franck B, Gehrken HP. Angew Chem Int Ed Engl. 1980;19(6):461-2 Citreoviridins from Aspergillus terreus.Toxicity: Citreoviridin is produced by P. citreonigrum (synonyms P. citreoviride and P. toxicarium), particularly in rice after harvest. It can cause cardiac beriberi in man. Acute cardiac beriberi in Japan is now only of historical interest although P. citreonigrum and citreoviridin are still reported in other parts of Asia. The fungus is said to be favoured by the lower temperatures and shorter hours of daylight occurring in the more temperate rice growing areas. The toxin is also produced by P. ochrosalmoneum. Citreoviridin has been found in un-harvested corn in the USA. Citreoviridin is an unusual molecule consisting of a lactone ring conjugated to a furan ring, with a molecular weight of 402. It is a neurotoxin. Nishie K, Cole RJ, Dorner JW. Res Commun Chem Pathol Pharmacol. 1988 Jan;59(1):31-52.Toxicity of citreoviridin.
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After 3 weeks of posaconazole given for chronic pulmonary aspergillosis, patient NC had a remarkable exacerbation of psoriasis. He had had psoriasis for years, with little trouble and almost no treatment. After taking posaconazole 400mg twice daily, he developed psoriatic plaques on his hands for the first time ever. The plaques on his lower legs became confluent. This occurred in association with worsening chest symptoms, notably increased coughing, more breathlessness and increasing oxygen requirement.
Posaconazole was stopped after 3 weeks, and 2 weeks later he was still very symptomatic with his chest. This responded to a 2 week course of corticosteroids, and his psoriasis also improved.
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Patient PC: An example of localised caspofungin rash and phlebitis related to caspofungin infusion.
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This 55 year old man with asthma, ABPA, severe bronchiectasis and lung fibrosis was treated with voriconazole, starting in June 2010. He had developed increasing dyspnoea on itraconazole for over 7 years, and his total IgE remained at 1100 KIU/L. He had marked photopsia (visual hallucinations) and facial erythema in the first 3 weeks of therapy. His trough voriconazole concentration was 1.17 mg/L. Over 3 months, he had minor improvement in his breathlessness but continued facial erythema, despite factor 50 sunblock. After 5 months of therapy his facial rash has altered to show acneiform lesions with localised crusting and background severe erythema. His face effectively crusted over, and he stopped therapy.
Over the next 3 weeks his facial appearance slowly improved .
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