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Post-influenzal triazole-resistant aspergillosis following allogeneic stem cell transplantation
Alida Fe Talento1,2, Katie Dunne1, Niamh Murphy2
1Department of Clinical Microbiology, Trinity College Dublin, Dublin 8, Ireland.
Abstract:
Influenza virus infection is now recognised as a risk factor for invasive pulmonary aspergillosis (IPA). Delays in diagnosis contribute to delayed commencement of antifungal therapy. In addition, the emergence of resistance to first-line triazole antifungal agents puts emphasis on early detection to prevent adverse outcomes. We present 2 allogeneic stem cell transplant patients who developed IPA due to triazole-resistant Aspergillus fumigatus following influenza infection. We underline the challenges faced in the management of these cases, the importance of early diagnosis and need for surveillance given the emergence of triazole resistance.
Insights
Influenza infection increases the risk of invasive pulmonary aspergillosis (IPA). Early diagnosis and surveillance are crucial, especially with emerging antifungal resistance in Aspergillus fumigatus.
Area of Science:
- Mycology
- Infectious Diseases
- Hematology
Background:
- Influenza virus infection is an emerging risk factor for invasive pulmonary aspergillosis (IPA).
- Delayed diagnosis of IPA leads to delayed antifungal therapy.
- Antifungal resistance in Aspergillus fumigatus necessitates early detection strategies.
Observation:
- Two allogeneic stem cell transplant recipients developed IPA following influenza infection.
- The IPA cases were caused by triazole-resistant Aspergillus fumigatus.
- Management of these cases presented significant clinical challenges.
Findings:
- Influenza infection can predispose immunocompromised patients to invasive pulmonary aspergillosis.
- Triazole-resistant Aspergillus fumigatus poses a threat in post-influenza settings.
- Early and accurate diagnosis is critical for effective treatment of IPA.
Implications:
- Highlights the need for increased vigilance for IPA in influenza patients, particularly transplant recipients.
- Emphasizes the importance of diagnostic strategies to identify triazole resistance.
- Underscores the necessity of antifungal surveillance programs to monitor resistance patterns.
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