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成人患者感染赖特曲霉所致侵袭性肺曲霉病:病例报告及文献复习。

Invasive pulmonary aspergillosis due to Aspergillus lentulus in an adult patient: A case report and literature review.

机构信息

Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.

Department of Connective Tissue Diseases, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.

出版信息

J Infect Chemother. 2019 Jul;25(7):547-551. doi: 10.1016/j.jiac.2019.02.003. Epub 2019 Feb 26.

Abstract

Aspergillus fumigatus is the commonest cause of pulmonary aspergillosis; however, a recently developed molecular genetic technique identified A. lentulus as a sibling species. Most of the isolates were found in solid organ recipients, often associated with a fatal outcome. Moreover, there is concern that A. lentulus has low susceptibility to multiple antifungal agents. Herein, we report an adult immunocompromised patient with proven invasive pulmonary aspergillosis (IPA) caused by A. lentulus, which was identified through molecular genetic analysis. The patient was diagnosed with IPA by bronchoscopy 3 weeks after initiating systemic corticosteroid therapy for anti-neutrophil cytoplasmic antibody-associated vasculitis. The clinical course of IPA due to A. lentulus showed improvement after treatment with the antifungal agent voriconazole. In summary, we report an adult immunocompromised patient without a history of transplantation who was diagnosed with IPA due to A. lentulus successfully treated with voriconazole, and we also report the findings of a literature review on IPA caused by A. lentulus.

摘要

烟曲霉是最常见的肺部曲霉菌病的病原体; 然而,最近开发的分子遗传技术鉴定出 lentulus 为一个姊妹种。大多数分离株发现于实体器官受者中,通常与致命结局相关。此外,人们担心 lentulus 对多种抗真菌药物的敏感性降低。在此,我们报告了一例成人免疫功能低下患者,通过分子遗传分析证实患有由 lentulus 引起的侵袭性肺曲霉病(IPA)。该患者在因抗中性粒细胞胞质抗体相关性血管炎开始全身皮质类固醇治疗后 3 周,通过支气管镜检查诊断为 IPA。使用伏立康唑治疗后,由 lentulus 引起的 IPA 的临床病程有所改善。总之,我们报告了一例成人免疫功能低下患者,无移植史,经伏立康唑成功治疗,诊断为 lentulus 引起的 IPA,并对由 lentulus 引起的 IPA 的文献复习结果进行了报告。

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