Xu Lulu, Tao Lili
Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37228, USA.
Chongqing Clinical Research Center for Geriatric Diseases, Department of Geriatrics, Chongqing General Hospital, Chongqing University, Chongqing 401147, China.
J Fungi (Basel). 2025 Aug 29;11(9):634. doi: 10.3390/jof11090634.
species are thermophilic, darkly pigmented fungi commonly found in hot environments. Despite their environmental ubiquity, fewer than fifty human infections have been reported, with responsible for most cases. While infections primarily occur in immunocompromised individuals, only six cases in immunocompetent patients have been documented. We describe a case of pulmonary infection in a 75-year-old immunocompetent woman. Despite broad-spectrum antifungal treatments, including liposomal amphotericin B and voriconazole, the patient's condition deteriorated. Bronchoalveolar lavage (BAL) revealed hyphal forms, and fungal culture identified a species. Antifungal susceptibility tests showed low minimal inhibitory concentrations (MICs) for amphotericin B (1 μg/mL) and voriconazole (0.5 μg/mL). Clinical manifestations of infection in immunocompetent pneumonia patients are non-specific. Structural lung disease was identified as the primary risk factor in such hosts. BAL fungal cultures and metagenomics are valuable tools in diagnosing rare fungal infections. Treatment regimens vary, with amphotericin B and triazoles being the most commonly used antifungal agents. Currently, there are no standardized guidelines for diagnosis or treatment. Further studies are needed to establish clinical protocols.
该物种是嗜热、色素沉着深的真菌，常见于炎热环境中。尽管它们在环境中普遍存在，但报告的人类感染病例不到50例，其中大多数病例由其引起。虽然感染主要发生在免疫功能低下的个体中，但有记录的免疫功能正常患者仅有6例。我们描述了一名75岁免疫功能正常女性的肺部感染病例。尽管采用了包括脂质体两性霉素B和伏立康唑在内的广谱抗真菌治疗，但患者的病情仍恶化。支气管肺泡灌洗（BAL）显示有菌丝形态，真菌培养鉴定出该物种。抗真菌药敏试验显示两性霉素B（1μg/mL）和伏立康唑（0.5μg/mL）的最低抑菌浓度（MIC）较低。免疫功能正常的肺炎患者感染的临床表现是非特异性的。结构性肺病被确定为此类宿主的主要危险因素。BAL真菌培养和宏基因组学是诊断罕见真菌感染的有价值工具。治疗方案各不相同，两性霉素B和三唑类是最常用的抗真菌药物。目前，尚无诊断或治疗的标准化指南。需要进一步研究以建立临床方案。
