Clinical features:
(1) The patient usually has one or more risk factors for pythiosis, usually thalassemia or paroxysmal noctural hemoglobinuria (PNH).
(2) It may be associated with vascular pythiosis.
(3) Lesions are found in multiple organs (spleen, liver, lungs, kidneys, brain, gastrointestinal tract, pleural fluid, peritoneal fluid, pericardial fluid, paranasal sinuses, etc).
(4) Secondary infection with sepsis may develop.
(5) Poor clinical response to systemic antifungal therapy.
Laboratory findings:
(1) fungal hyphae in tissue biopsies
(2) positive fungal culture for Pythium insidiosum
Exclusion of other diagnoses (especially Aspergillosis and Mucormycosis) may be important in reaching the final diagnosis.
Immunotherapy may be helpful if the person survives long enough.
