Fig 1.
Maximum likelihood phylogeny inferred using RAxML v. 8.0.0 employing GTRCAT model and 1,000 bootstrap replicates.
Bootstrap branch support above 80% is shown. Multiple sequences in the same species are collapsed. Genera included in the family Ajellomycetaceae are shown, with the exception of Lacazia loboi, which could not meaningfully be aligned.
Fig 2.
Clinical, pathological, and mycological facets of a novel Emmonsia-like fungus reported from South Africa.
Top left: Hyperkeratotic skin lesions in a patient with disseminated Emmonsia disease (published with patient consent; courtesy of Dr. Tabie Greyling, Stellenbosch University). Top right: Peripheral blood smear showing neutrophils with multiple phagocytosed yeast-like cells (Wright-Giemsa staining x1,000). Bottom right: Electron microscopy image of conidia (courtesy of Dr. Monica Birkhead, National Institute of Communicable Diseases). Bottom left: Light microscopy image of conidiophores and conidia (x1,000).
Fig 3.
Timeline of human cases of disease caused by classical Emmonsia species (with adiaspores at 37°C) and novel Emmonsia-like species (with yeast cells at 37°C).
Vertical bars represent number of cases during 5-year intervals, as determined by literature review. The increase in cases of diseases caused by novel Emmonsia-like species occurring between 2006 and 2015 is primarily driven by recognition of HIV-associated cases in South Africa following the introduction of molecular identification protocols for dimorphic fungal infections in 2008.