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Invasive aspergillosis caused by Aspergillus ustus: case report and review
P E Verweij1, M F van den Bergh, P M Rath
1Departments of Medical Microbiology, University Hospital Nijmegen, Nijmegen, The Netherlands. p.verweij@mmb.azn.nl
Abstract:
A case of invasive pulmonary aspergillosis in an allogeneic bone marrow transplant recipient caused by Aspergillus ustus is presented. A. ustus was also recovered from the hospital environment, which may indicate that the infection was nosocomially acquired. A literature review revealed seven cases of invasive infections caused by A. ustus, and three of these were primarily cutaneous infections. In vitro susceptibility testing of 12 A. ustus isolates showed that amphotericin B and terbinafine had fungicidal activity and that itraconazole and voriconazole had fungistatic activity.
Insights
A rare Aspergillus ustus fungal infection occurred in a bone marrow transplant patient, possibly acquired in the hospital. This study details the case and treatment options for invasive aspergillosis.
Area of Science:
- Mycology
- Infectious Diseases
- Hematology
Background:
- Allogeneic bone marrow transplant recipients are immunocompromised, increasing susceptibility to opportunistic infections.
- Invasive pulmonary aspergillosis is a serious complication in transplant patients, often caused by Aspergillus fumigatus.
- Aspergillus ustus is an emerging fungal pathogen with limited data on invasive infections.
Observation:
- A case of invasive pulmonary aspergillosis caused by Aspergillus ustus in an allogeneic bone marrow transplant recipient is described.
- Aspergillus ustus was identified in the hospital environment, suggesting a potential nosocomial source of infection.
- A literature review identified seven previous cases of invasive Aspergillus ustus infections, with three being cutaneous.
Findings:
- In vitro susceptibility testing revealed that amphotericin B and terbinafine demonstrated fungicidal activity against Aspergillus ustus isolates.
- Itraconazole and voriconazole exhibited fungistatic activity against the tested Aspergillus ustus isolates.
- This highlights varying treatment efficacies for invasive Aspergillus ustus infections.
Implications:
- Early recognition and diagnosis of Aspergillus ustus infections are crucial in immunocompromised patients.
- Environmental surveillance for Aspergillus species may be important in preventing nosocomial infections in transplant centers.
- Understanding antifungal susceptibility patterns is vital for guiding effective therapeutic strategies against invasive Aspergillus ustus.