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Invasive aspergillosis in a patient with MELAS syndrome
D H McKee1, P N Cooper, D W Denning
1Department of Neurology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. DMcKee@Central.CMHT.NWest.NHS.uk
Abstract:
Invasive infection with the opportunistic fungus Aspergillus fumigatus predominantly affects people with impaired cell mediated immunity. The case of a 31 year old woman with no identified cause for immunosuppression who presented with severe refractory aspergillosis of the paranasal sinuses is reported. She subsequently developed clinical and molecular evidence of mitochondrial encephalomyopathy with lactic acidosis and stroke-like events (MELAS) syndrome. It is proposed that MELAS syndrome may represent an unusual risk factor for the development of invasive aspergillosis and mechanisms are supported by which mitochondrial dysfunction may predispose to this.
Insights
Mitochondrial encephalomyopathy with lactic acidosis and stroke-like events (MELAS) syndrome may be an unusual risk factor for invasive aspergillosis. This case highlights mitochondrial dysfunction
Area of Science:
- Clinical Mycology
- Neurogenetics
- Immunology
Background:
- Invasive aspergillosis is a serious opportunistic infection primarily affecting individuals with compromised cell-mediated immunity.
- Aspergillus fumigatus is a common fungal pathogen responsible for invasive infections.
Observation:
- A case report of a 31-year-old woman with severe, refractory paranasal sinus aspergillosis is presented.
- The patient had no identifiable cause for immunosuppression prior to the aspergillosis diagnosis.
- Subsequently, she developed clinical and molecular evidence of mitochondrial encephalomyopathy with lactic acidosis and stroke-like events (MELAS) syndrome.
Findings:
- The study proposes that MELAS syndrome could be an unrecognized risk factor for invasive aspergillosis.
- Mechanisms linking mitochondrial dysfunction to increased susceptibility to invasive fungal infections are discussed.
Implications:
- This finding suggests a potential link between mitochondrial disorders and invasive fungal infections, broadening the understanding of aspergillosis risk factors.
- Further research into mitochondrial dysfunction's role in immunocompromised states is warranted.
- Clinical awareness of MELAS syndrome as a potential risk factor for aspergillosis may improve patient outcomes.