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Published on: March 22, 2012
A Case Report on Aspergillus lentulus Pneumonia
Saban Gürcan1, Melek Tikveşli1, Sedat Ustündağ2
1Department of Medical Microbiology, Trakya University Faculty of Medicine, Edirne, Turkey.
Background:
Aspergillus lentulus was described as a new species in 2005 but it was isolated from Turkey for the first time.
Case Report:
A. lentulus was isolated as the cause of pneumonia from a patient who had renal transplantation 4 months ago. The patient received immunosuppressive treatment after transplantation. A. lentulus was isolated from his sputum as an agent in pneumonia developed 4 months after the transplantation. Leukocytes, blastospores, and hyphae were seen in both Gram- and Giemsastained smears of the sputum. The isolate was identified by using the Maren A. Klich algorithm and molecular methods and confirmed by the reference laboratory of the CBS Fungal Biodiversity Centre (The Netherlands). In the susceptibility tests of the isolate, minimal inhibitory concentrations for amphotericin B, voriconazole, posaconazole, and caspofungin were found to be 0.5 μg/mL, 0.25 μg/mL, 0.125 μg/mL, and 0.25 μg/mL, respectively. The patient recovered with voriconazole treatment (2×200 mg/day).
Conclusion:
The use of the molecular tests is important for identification of A. lentulus strains because they are very easily confused with A.fumigatus strains according to phenotypic characteristics.
Insights
This study reports the first isolation of Aspergillus lentulus in Turkey from a kidney transplant patient with pneumonia. Molecular identification and susceptibility testing were crucial for successful voriconazole treatment.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Aspergillus lentulus, a fungal species described in 2005, has been isolated from Turkey for the first time.
- This marks a significant finding in the geographical distribution of this pathogen.
Purpose of the Study:
- To report the first case of Aspergillus lentulus isolation in Turkey.
- To detail the clinical presentation, identification, and treatment of a patient with A. lentulus pneumonia.
- To highlight the importance of molecular identification for Aspergillus species.
Main Methods:
- Isolation and identification of Aspergillus lentulus from patient sputum using Maren A. Klich algorithm and molecular methods.
- Microscopic examination of Gram- and Giemsa-stained sputum smears.
- Antifungal susceptibility testing against amphotericin B, voriconazole, posaconazole, and caspofungin.
- Confirmation by a reference laboratory.
Main Results:
- Aspergillus lentulus was identified as the causative agent of pneumonia in an immunosuppressed renal transplant recipient.
- The patient's isolate showed specific minimal inhibitory concentrations (MICs) for tested antifungals.
- Successful treatment was achieved with voriconazole (2x200 mg/day).
Conclusions:
- Molecular identification methods are essential for accurately distinguishing Aspergillus lentulus from morphologically similar species like Aspergillus fumigatus.
- Early and accurate diagnosis and targeted antifungal therapy are critical for managing invasive aspergillosis in immunocompromised patients.
