Kinch Amelie, Furebring Mia, Chryssanthou Erja, Hallböök Helene
Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden.
Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
Med Mycol Case Rep. 2022 Dec 24;39:26-30. doi: 10.1016/j.mmcr.2022.12.005. eCollection 2023 Mar.
We report for the first time a case of disseminated infection caused by , a mold not previously associated with invasive infections in humans. occurs in natural and sterilized soil and may cause hypersensitivity pneumonitis in greenhouse workers. The immunocompromised patient presented with neutropenic fever that did not respond to broad-spectrum antibiotics and developed multiple skin and lung lesions. A skin biopsy demonstrated an angioinvasive mold, identified as by culture and DNA sequencing. Minimum inhibitory concentration (MIC) for amphotericin B was 0.125 mg/L, for isavuconazole 0.125 mg/L, for voriconazole 0.06 mg/L, and for posaconazole 0.03 mg/L. The skin lesions have resolved completely, and the lung lesions have decreased significantly in size after 14 months of mold-active antifungal therapy, mostly isavuconazole. In conclusion, species can be opportunistic pathogens causing considerable morbidity in immunocompromised hosts. The infection may be successfully treated with mold-active antifungal drugs.
我们首次报告了一例由 引起的播散性感染病例， 是一种此前未与人类侵袭性感染相关的霉菌。 存在于天然和经过灭菌处理的土壤中，可能导致温室工人患过敏性肺炎。这位免疫功能低下的患者出现了对广谱抗生素无反应的中性粒细胞减少性发热，并出现了多处皮肤和肺部病变。皮肤活检显示为血管侵袭性霉菌，通过培养和DNA测序鉴定为 。两性霉素B的最低抑菌浓度（MIC）为0.125mg/L，艾沙康唑为0.125mg/L，伏立康唑为0.06mg/L，泊沙康唑为0.03mg/L。经过14个月的抗霉菌活性抗真菌治疗（主要是艾沙康唑）后，皮肤病变已完全消退，肺部病变大小显著减小。总之， 菌种可能是导致免疫功能低下宿主出现相当高发病率的机会性病原体。使用抗霉菌活性抗真菌药物可成功治疗该感染。
