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Proven Invasive Pulmonary Aspergillosis in Stem Cell Transplant Recipient Due to Aspergillus sublatus, a Cryptic Species of A. nidulans
V. Chrenkova, V. Hubka, P. Cetkovsky, M. Kouba, B. Weinbergerova, P. Lyskova, L. Hornofova, P. Hubacek,
Language English Country Netherlands
Document type Case Reports, Journal Article
NLK
ProQuest Central
from 1997-04-01 to 1 year ago
Medline Complete (EBSCOhost)
from 2011-01-01 to 1 year ago
Health & Medicine (ProQuest)
from 1997-04-01 to 1 year ago
- MeSH
- Antifungal Agents administration & dosage MeSH
- Aspergillus classification cytology genetics isolation & purification MeSH
- Leukemia, Lymphocytic, Chronic, B-Cell complications MeSH
- Cytomegalovirus Infections complications diagnosis MeSH
- DNA, Fungal chemistry genetics MeSH
- Fatal Outcome MeSH
- Phylogeny MeSH
- Invasive Pulmonary Aspergillosis diagnosis drug therapy microbiology pathology MeSH
- Calmodulin genetics MeSH
- Middle Aged MeSH
- Humans MeSH
- DNA, Ribosomal Spacer chemistry genetics MeSH
- Microbial Sensitivity Tests MeSH
- Microscopy, Electron, Scanning MeSH
- Graft vs Host Disease complications diagnosis MeSH
- Transplant Recipients MeSH
- Sequence Analysis, DNA MeSH
- Cluster Analysis MeSH
- Hematopoietic Stem Cell Transplantation adverse effects MeSH
- Tubulin genetics MeSH
- Hepatitis, Viral, Human complications diagnosis MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
Invasive fungal disease represents one of the severe complications in haematopoietic stem cell transplant recipients. We describe a case of a patient treated for relapse of chronic lymphoblastic leukaemia 6 years after HSCT. The patient was treated for invasive pulmonary aspergillosis but died 3 months later from multiple organ failures consisting of haemorrhagic necrotizing fungal pneumonia, refractory chronic hepatic graft versus host disease and cytomegalovirus hepatitis. Autopsy samples revealed histopathological evidence of fungal hyphae and an unusual Aspergillus nidulans-like species was isolated in pure culture. More precise identification was achieved by using scanning electron microscopy of ascospores and sequencing of calmodulin gene, and the isolate was subsequently re-identified as A. sublatus (section Nidulantes) and showed good in vitro susceptibility against all classes of antifungals. Commonly used ITS rDNA region and β-tubulin gene fail to discriminate A. sublatus from related pathogenic species, especially A. quadrilineatus and A. nidulans. Although this is the first case of proven IPA attributed to A. sublatus, we demonstrated that at least some previously reported infections due to A. quadrilineatus were probably caused by this cryptic species.
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- $a Chrenková, Vanda $u Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Uvalu 84, 15006, Prague 5, Czech Republic. vanda.chrenkova@fnmotol.cz. $7 xx0159343
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- $a Invasive fungal disease represents one of the severe complications in haematopoietic stem cell transplant recipients. We describe a case of a patient treated for relapse of chronic lymphoblastic leukaemia 6 years after HSCT. The patient was treated for invasive pulmonary aspergillosis but died 3 months later from multiple organ failures consisting of haemorrhagic necrotizing fungal pneumonia, refractory chronic hepatic graft versus host disease and cytomegalovirus hepatitis. Autopsy samples revealed histopathological evidence of fungal hyphae and an unusual Aspergillus nidulans-like species was isolated in pure culture. More precise identification was achieved by using scanning electron microscopy of ascospores and sequencing of calmodulin gene, and the isolate was subsequently re-identified as A. sublatus (section Nidulantes) and showed good in vitro susceptibility against all classes of antifungals. Commonly used ITS rDNA region and β-tubulin gene fail to discriminate A. sublatus from related pathogenic species, especially A. quadrilineatus and A. nidulans. Although this is the first case of proven IPA attributed to A. sublatus, we demonstrated that at least some previously reported infections due to A. quadrilineatus were probably caused by this cryptic species.
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