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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
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Cryptic aspergillosis: a rare entity and a diagnostic challenge

Lavanya R1, Marilyn M Ninan1, Regi Kurien2

  • 1Department of Clinical Microbiology, Christian Medical College, Vellore 632004, India.

Access Microbiology
|July 11, 2022
PubMed
Abstract

Insights

Cryptic aspergillosis, caused by challenging-to-identify Aspergillus species, requires advanced molecular methods for accurate diagnosis. This study highlights the diagnostic difficulties and emphasizes the need for precise identification in clinical settings.

Area of Science:

  • Medical Mycology
  • Clinical Microbiology
  • Infectious Diseases

Background:

  • Cryptic aspergillosis, emerging from cryptic Aspergillus species, poses a significant threat to immunocompromised individuals.
  • Accurate identification of these fungal pathogens is crucial for effective patient management and treatment.

Observation:

  • This retrospective study reviewed cryptic Aspergillus infections diagnosed between April 2019 and February 2020 at a tertiary care center.
  • Conventional methods, MALDI-TOF MS, and molecular sequencing (28S rRNA and ITS) were employed for isolate identification.
  • Identified species included Aspergillus tamarii, Aspergillus lentulus, and Aspergillus sydowii.

Findings:

  • MALDI-TOF MS and sequencing showed concordance for most isolates, but misidentified Aspergillus sydowii as Aspergillus thermomutans.
  • All identified cryptic Aspergillus isolates exhibited low minimum inhibitory concentrations (MICs) to antifungal drugs.
  • Cryptic Aspergillus species present considerable diagnostic challenges in routine laboratory settings.

Implications:

  • Accurate identification of cryptic Aspergillus species is essential for appropriate antifungal therapy selection.
  • Molecular identification methods are critical for overcoming the limitations of conventional techniques and mass spectrometry.
  • Enhanced diagnostic strategies are needed to improve patient outcomes in cases of cryptic aspergillosis.
Keywords:
AFST (antifungal susceptibility testing)ITS sequencingMALDI-TOF MS (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry)MEC (minimum effective concentration)cryptic species

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