Inaba Takumi, Minami Kensuke, Ishioka Haruhiko, Sekiguchi Kazumasa, Watanabe Akira, Hatakeyama Shuji
Division of Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan; Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan.
Division of Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan.
J Infect Chemother. 2025 May;31(5):102691. doi: 10.1016/j.jiac.2025.102691. Epub 2025 Mar 29.
A 67-year-old Japanese man with alcoholic liver cirrhosis without any other known immunosuppressive conditions presented with a solitary brain abscess caused by Aspergillus tubingensis. A. tubingensis, a cryptic species within the Aspergillus section Nigri, has been reported to exhibit resistance to voriconazole. This case highlights the necessity for considering central nervous system aspergillosis as a differential diagnosis, even in patients without significant immunosuppression. Moreover, molecular identification and antifungal susceptibility testing are crucial for accurate diagnosis and effective management of such infections, as cryptic species within the Aspergillus genus may exhibit varying degrees of resistance to established treatments.
一名67岁的日本男性，患有酒精性肝硬化，无其他已知的免疫抑制情况，因土曲霉引起单发脑脓肿就诊。土曲霉是曲霉属黑曲霉组中的一个隐性种，据报道对伏立康唑耐药。该病例强调，即使在无明显免疫抑制的患者中，也有必要将中枢神经系统曲霉病作为鉴别诊断考虑。此外，分子鉴定和抗真菌药敏试验对于此类感染的准确诊断和有效管理至关重要，因为曲霉属内的隐性种可能对既定治疗表现出不同程度的耐药性。
