Proven Invasive Pulmonary Aspergillosis in Stem Cell Transplant Recipient Due to Aspergillus sublatus, a Cryptic Species of A. nidulans

Autor: Pavlina Lyskova, Ludmila Hornofova, Vit Hubka, Petr Hubacek, Vanda Chrenková, Petr Cetkovsky, Barbora Weinbergerova, Michal Kouba
Rok vydání: 2017
Předmět:
Male
0301 basic medicine
medicine.medical_specialty
Pathology
Antifungal Agents
Hepatitis
Viral
Human
Veterinary (miscellaneous)
medicine.medical_treatment
030106 microbiology
Graft vs Host Disease
Autopsy
Microbial Sensitivity Tests
Hematopoietic stem cell transplantation
Applied Microbiology and Biotechnology
Microbiology
03 medical and health sciences
Fatal Outcome
Medical microbiology
Calmodulin
Tubulin
DNA
Ribosomal Spacer
medicine
Cluster Analysis
Humans
DNA
Fungal
Phylogeny
Invasive Pulmonary Aspergillosis
Aspergillus
biology
Hematopoietic Stem Cell Transplantation
Sequence Analysis
DNA
Middle Aged
Fungal pneumonia
medicine.disease
biology.organism_classification
Leukemia
Lymphocytic
Chronic
B-Cell
Transplant Recipients
Haematopoiesis
030104 developmental biology
Graft-versus-host disease
Cytomegalovirus Infections
Microscopy
Electron
Scanning
Stem cell
Agronomy and Crop Science
Zdroj: Mycopathologia. 183:423-429
ISSN: 1573-0832
0301-486X
Popis: Invasive fungal disease represents one of the severe complications in haematopoietic stem cell transplant recipients. We describe a case of a patient treated for relapse of chronic lymphoblastic leukaemia 6 years after HSCT. The patient was treated for invasive pulmonary aspergillosis but died 3 months later from multiple organ failures consisting of haemorrhagic necrotizing fungal pneumonia, refractory chronic hepatic graft versus host disease and cytomegalovirus hepatitis. Autopsy samples revealed histopathological evidence of fungal hyphae and an unusual Aspergillus nidulans-like species was isolated in pure culture. More precise identification was achieved by using scanning electron microscopy of ascospores and sequencing of calmodulin gene, and the isolate was subsequently re-identified as A. sublatus (section Nidulantes) and showed good in vitro susceptibility against all classes of antifungals. Commonly used ITS rDNA region and β-tubulin gene fail to discriminate A. sublatus from related pathogenic species, especially A. quadrilineatus and A. nidulans. Although this is the first case of proven IPA attributed to A. sublatus, we demonstrated that at least some previously reported infections due to A. quadrilineatus were probably caused by this cryptic species.
Databáze: OpenAIRE
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