Successful Treatment of Invasive Fungal Infection Due to Highly Resistant Aspergillus calidoustus in an Allogeneic Hematopoietic Cell Transplant Recipient

Research output: Contribution to journalArticle

Abstract

Invasive aspergillosis (IA) is the most common invasive fungal infection following a hematopoietic cell transplant, with emerging cryptic species exhibiting resistance to commonly used antifungals such as azoles. These species have been increasingly found after the introduction of anti-mold prophylaxis. We report a case of a 56-year-old female with primary myelofibrosis whose allogeneic hematopoietic cell transplant was complicated by disseminated fungal infection (skin, lung) due to Aspergillus calidoustus, a cryptic specie. Treatment of Aspergillus species remains challenging as these cryptic species are usually resistant to azoles including voriconazole which is the first line of treatment of IA. Infection was successfully treated with surgical excision and combination antifungal therapy based on in vitro susceptibility and synergy testing. Therapy included isavuconazole, a drug that has been shown to be non-inferior to voriconazole in the treatment of invasive mold infections.

Original languageEnglish (US)
Pages (from-to)399-403
Number of pages5
JournalMycopathologia
Volume185
Issue number2
DOIs
StatePublished - Apr 1 2020

Keywords

  • Antifungal susceptibility testing
  • Antifungal therapy
  • Aspergillus calidoustus
  • Aspergillus ustus
  • Cryptic species
  • Invasive aspergillosis
  • Isavuconazole

ASJC Scopus subject areas

  • Microbiology
  • Applied Microbiology and Biotechnology
  • Agronomy and Crop Science
  • veterinary (miscalleneous)

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