Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, National Center for Children's Health, Beijing, China.
Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands.
Mycopathologia. 2024 May 11;189(3):44. doi: 10.1007/s11046-024-00848-z.
A 50-year-old man, previously diagnosed with pulmonary tuberculosis and lung cavities, presented with symptoms including fever, shortness of breath, and cough. A pulmonary CT scan revealed multiple cavities, consolidation and tree-in-bud in the upper lungs. Further investigation through direct examination of bronchoalveolar lavage fluid showed septate hyphae with dichotomous acute branching. Subsequent isolation and morphological analysis identified the fungus as belonging to Aspergillus section Nigri. The patient was diagnosed with probable invasive pulmonary aspergillosis and successfully treated with a three-month oral voriconazole therapy. Phylogenetic analysis based on partial β-tubulin, calmodulin and RNA polymerase second largest subunit sequences revealed that the isolate represents a putative new species related to Aspergillus brasiliensis, and is named Aspergillus hubkae here. Antifungal susceptibility testing demonstrated that the isolate is resistant to itraconazole but susceptible to voriconazole. This phenotypic and genetic characterization of A. hubkae, along with the associated case report, will serve as a valuable resource for future diagnoses of infections caused by this species. It will also contribute to more precise and effective patient management strategies in similar clinical scenarios.
一位 50 岁男性,既往诊断为肺结核和肺空洞,出现发热、呼吸急促和咳嗽等症状。肺部 CT 扫描显示上肺部多个空洞、实变和树芽征。通过支气管肺泡灌洗液直接检查进一步发现分隔菌丝,具有二叉锐角分枝。随后的分离和形态分析确定真菌属于曲霉属 Nigri 组。患者被诊断为疑似侵袭性肺曲霉病,并成功接受了三个月的口服伏立康唑治疗。基于部分β-微管蛋白、钙调蛋白和 RNA 聚合酶第二大亚基序列的系统发育分析表明,该分离株代表与巴西曲霉相关的假定新种,现命名为 hubkae 曲霉。抗真菌药敏试验表明,该分离株对伊曲康唑耐药,但对伏立康唑敏感。该 A. hubkae 的表型和遗传特征,以及相关病例报告,将为未来诊断该物种引起的感染提供有价值的资源。它还将有助于在类似临床情况下制定更精确和有效的患者管理策略。