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Lethal destructive sinusopathy due to amphotericin B-resistant Aspergillus flavus: A case report
Tiago Luiz Lagedo Ferraz1, Eduardo Marques Araújo2, Rodolfo Froes Calixto1
1Real Hospital Português de Beneficência, Recife, Pernambuco State, Brazil.
Revista Iberoamericana De Micologia
|March 8, 2022
Summary
Invasive fungal infections from resistant Aspergillus flavus in immunocompromised patients can be fatal. Antifungal susceptibility testing is crucial for effective treatment of invasive aspergillosis.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Hematology
Background:
- Pulmonary aspergillosis is common, but non-pulmonary involvement, like pansinusopathy, is rare, especially in immunocompromised hosts.
- Recent findings indicate Aspergillus flavus strains resistant to antifungal drugs are emerging.
- Nasal sinus infections by resistant Aspergillus in immunocompromised patients pose a significant mortality risk.
Observation:
- A case of invasive Aspergillus flavus infection in an allogeneic hematopoietic stem cell transplant recipient is presented.
- The patient experienced febrile neutropenia, prolonged antibiotic use, and antifungal prophylaxis.
- Brain MRI revealed pansinusopathy, and nasal necrosis was observed.
Findings:
- Microscopic examination showed septate hyphae and conidiophores consistent with Aspergillus.
- MALDI-TOF MS identified the species as Aspergillus flavus.
- Antifungal susceptibility testing revealed resistance to amphotericin B.
Implications:
- Invasive fungal infections caused by amphotericin B-resistant Aspergillus flavus can be lethal due to treatment failure.
- Antifungal susceptibility testing is critical for guiding appropriate treatment strategies.
- This case underscores the importance of considering resistant fungal infections in immunocompromised patients with severe sinus infections.
Keywords:
Antifungal resistanceAspergillosisAspergilosisPansinusopathyPansinusopatíaResistencia antifúngicaMore Related Videos
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