Bertin-Biasutto Lise, Paccoud Olivier, Garcia-Hermoso Dea, Denis Blandine, Boukris-Sitbon Karine, Lortholary Olivier, Bretagne Stéphane, Gits-Muselli Maud, Herbrecht Raoul, Letscher-Bru Valérie, Danion François, Cassaing Sophie, Morio Florent, Nourrisson Céline, Pihet Marc, Sasso Milène, Desoubeaux Guillaume, Durieux Marie-Fleur, Bonhomme Julie, Chachaty Elisabeth, Chouaki Taieb, Desbois-Nogard Nicole, Alanio Alexandre, Gangneux Jean-Pierre, Lanternier Fanny
Emerg Infect Dis. 2025 May;31(5):896-905. doi: 10.3201/eid3105.241392.
Invasive aspergillosis (IA) caused by Aspergillus flavus remains poorly described. We retrospectively analyzed 54 cases of IA caused by A. flavus reported in France during 2012-2018. Among cases, underlying IA risk factors were malignancy, solid organ transplantation, and diabetes. Most (87%, 47/54) infections were localized, of which 33 were pleuropulmonary and 13 were ear-nose-throat (ENT) infection sites. Malignancy (70% [23/33]) and solid organ transplantation (21% [7/33]) were the main risk factors in localized pulmonary infections, and diabetes mellitus was associated with localized ENT involvement (61.5%, [8/13]). Fungal co-infections were frequent in pulmonary (36%, 12/33) but not ENT IA (0 cases). Antifungal monotherapy was prescribed in 45/50 (90%) cases, mainly voriconazole (67%, 30/45). All-cause 30-day case-fatality rates were 39.2% and 90-day rates were 47.1%, and rates varied according to risk factor, IA site, and fungal co-infections. Clinicians should remain vigilant for A. flavus and consider it in the differential diagnosis for IA.
由黄曲霉引起的侵袭性曲霉病（IA）的相关描述仍然很少。我们回顾性分析了2012年至2018年期间法国报告的54例由黄曲霉引起的IA病例。在这些病例中，潜在的IA危险因素包括恶性肿瘤、实体器官移植和糖尿病。大多数（87%，47/54）感染为局限性感染，其中33例为胸膜肺部感染，13例为耳鼻喉（ENT）感染部位。恶性肿瘤（70%[23/33]）和实体器官移植（21%[7/33]）是局限性肺部感染的主要危险因素，而糖尿病与局限性耳鼻喉感染相关（61.5%，[8/13]）。肺部真菌合并感染很常见（36%，12/33），但耳鼻喉IA中没有（0例）。45/50（90%）例患者接受了抗真菌单药治疗，主要是伏立康唑（67%，30/45）。全因30天病死率为39.2%，90天病死率为47.1%，病死率因危险因素、IA部位和真菌合并感染而异。临床医生应警惕黄曲霉，并在IA的鉴别诊断中考虑到它。
