Appasami Kavi Priya, Gourav Sudesh, Mani Srinivas, Aggarwal Sanjoli, Xess Immaculata, Soneja Manish, Vikram Naval K, Mishra Himanshu, Gupta Sonakshi, Rana Bhaskar, Pandey Mragnayani, Singh Gagandeep
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Open Forum Infect Dis. 2025 Mar 27;12(4):ofaf182. doi: 10.1093/ofid/ofaf182. eCollection 2025 Apr.
A 61-year-old woman presented with progressive shortness of breath, cough with expectoration, hemoptysis, and fever for 2 months. On admission, altered parameters included low oxygen saturation, slightly elevated total leukocyte count, and elevated bilirubin and liver enzymes. Contrast-enhanced computed tomography of the chest revealed bilateral cystic bronchiectasis with multiple cavitary nodules. Ultrasonography of the abdomen revealed extrahepatic biliary obstruction, likely carcinomatous in etiology. She was started on antibiotics and percutaneous transhepatic biliary drainage was done. The patient had to be intubated owing to worsening respiratory function. Antifungals were added subsequently due to raised galactomannan levels, but the patient died due to refractory hypokalemia. Postmortem lung biopsy sample showed septate hyphae on direct microscopy. The culture of the mini-bronchoalveolar lavage sample, as well as postmortem lung biopsy, grew a dematiaceous mold. Sequencing of the internal transcribed spacer region of the 18S ribosomal DNA identified the isolate to be .
一名61岁女性出现进行性气短、咳痰咳嗽、咯血和发热2个月。入院时，异常参数包括低氧饱和度、总白细胞计数略有升高、胆红素和肝酶升高。胸部增强计算机断层扫描显示双侧囊性支气管扩张伴多个空洞结节。腹部超声显示肝外胆管梗阻，病因可能为癌性。给予抗生素治疗，并进行了经皮经肝胆管引流。由于呼吸功能恶化，患者不得不插管。随后因半乳甘露聚糖水平升高加用抗真菌药，但患者因难治性低钾血症死亡。尸检肺活检样本直接显微镜检查显示有分隔菌丝。微型支气管肺泡灌洗样本培养以及尸检肺活检培养出一种暗色霉菌。对18S核糖体DNA的内部转录间隔区进行测序确定分离株为…… （原文此处不完整）
