Internal Medicine, Goto Central Hospital, Goto, Japan.
Med Mycol. 2012 Aug;50(6):631-6. doi: 10.3109/13693786.2011.639036. Epub 2011 Dec 13.
Aspergillus udagawae and A. fumigatus share similar morphological features but they differ genetically. There is also an important clinical distinction as A. udagawae is less sensitive to amphotericin B than A. fumigatus. We encountered a rare case of bronchial infection due to A. udagawae that was successfully treated with voriconazole. An 82-year-old woman with diabetes mellitus complained of bloody sputum. Bronchoscopy revealed a white plugged region at the origin of the right bronchi B5. Cytological study revealed a clot composed of filamentous fungi and Aspergillus spp. was detected by culture. Molecular analysis revealed that the causative agent was A. udagawae, and voriconazole was used for the treatment. In comparison to A. fumigatus, the A. udagawae strain isolated in this case was less sensitive to amphotericin B, less virulent in immunosuppressed mice, and more sensitive to hydrogen peroxide, features that are almost identical to those of the previously reported isolates of the fungus. We should be aware of the emergence of new Aspergillus species that might pose a clinical threat.
乌达卡沃曲霉和烟曲霉具有相似的形态特征，但在基因上有所不同。此外，两者在临床上也有重要的区别，即乌达卡沃曲霉对两性霉素 B 的敏感性低于烟曲霉。我们遇到了一例因乌达卡沃曲霉引起的罕见支气管感染病例，该病例经伏立康唑治疗后成功治愈。一名 82 岁的糖尿病女性患者主诉痰中带血。支气管镜检查显示右支气管 B5 的起始处有一个白色堵塞区域。细胞学研究显示，血栓由丝状真菌组成，通过培养检测到曲霉菌属。分子分析显示，病原体为乌达卡沃曲霉，使用伏立康唑进行治疗。与烟曲霉相比，该病例中分离出的乌达卡沃曲霉对两性霉素 B 的敏感性较低，对免疫抑制小鼠的毒力较低，对过氧化氢更敏感，这些特征几乎与之前报道的该真菌的分离株相同。我们应该意识到可能对临床造成威胁的新型曲霉属的出现。
