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Chronic invasive aspergillosis caused by Aspergillus viridinutans.

Vinh DC, Shea YR, Jones PA, Freeman AF, Zelazny A, Holland SM - Emerging Infect. Dis. (2009)

Bottom Line: Aspergillus viridinutans, a mold phenotypically resembling A. fumigatus, was identified by gene sequence analyses from 2 patients.Disease was distinct from typical aspergillosis, being chronic and spreading in a contiguous manner across anatomical planes.We emphasize the recognition of fumigati-mimetic molds as agents of chronic or refractory aspergillosis.

View Article: PubMed Central - PubMed

Affiliation: National Institutes of Health, Bethesda, Maryland 20892-1684, USA.

ABSTRACT
Aspergillus viridinutans, a mold phenotypically resembling A. fumigatus, was identified by gene sequence analyses from 2 patients. Disease was distinct from typical aspergillosis, being chronic and spreading in a contiguous manner across anatomical planes. We emphasize the recognition of fumigati-mimetic molds as agents of chronic or refractory aspergillosis.

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Related in: MedlinePlus

Computed tomographic scan of thorax showing extension of infection with Aspergillus viridinutans into mediastinal structures (arrow).
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Figure 1: Computed tomographic scan of thorax showing extension of infection with Aspergillus viridinutans into mediastinal structures (arrow).

Mentions: Patient 1 was a 14-year-old boy with p47phox-deficient chronic granulomatous disease. He had Staphylococcus aureus liver abscesses at ages 5 and 10 years, Burkholderia cepacia complex pneumonia at age 6 years, and Serratia marcescens pneumonia at age 12 years. In February 2004, while the patient was receiving itraconazole prophylaxis, right-sided chest pain and fevers developed. A computed tomography (CT) scan showed a 2-cm right middle lobe nodule adjacent to the cardiac border and mediastinal lymphadenopathy abutting the superior vena cava and anterior pericardium (Figure 1). Lymph node biopsy yielded a mold morphologically identified as A. fumigatus. Treatment with voriconazole was initiated. Repeat imaging 1 week later showed slight enlargement of the mediastinal mass. One month later, there was continued enlargement of the lung nodule and mediastinal adenopathy with necrosis. Caspofungin was added. Two weeks later, a new right middle lobe infiltrate was noted. Antifungal therapy was changed to posaconazole. Over the next 2 months, there was expansion of the right lung infiltrates and lymphadenopathy. Treatment was modified to posaconazole and caspofungin. Serial imaging over the next 3 weeks showed regression of the lung consolidations and mediastinal mass. Four months later, with ongoing resolution of the thoracic disease, the patient began receiving a maintenance dosage of posaconazole. As of 5 years later, he had experienced no recurrence.


Chronic invasive aspergillosis caused by Aspergillus viridinutans.

Vinh DC, Shea YR, Jones PA, Freeman AF, Zelazny A, Holland SM - Emerging Infect. Dis. (2009)

Computed tomographic scan of thorax showing extension of infection with Aspergillus viridinutans into mediastinal structures (arrow).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2815978&req=5

Figure 1: Computed tomographic scan of thorax showing extension of infection with Aspergillus viridinutans into mediastinal structures (arrow).
Mentions: Patient 1 was a 14-year-old boy with p47phox-deficient chronic granulomatous disease. He had Staphylococcus aureus liver abscesses at ages 5 and 10 years, Burkholderia cepacia complex pneumonia at age 6 years, and Serratia marcescens pneumonia at age 12 years. In February 2004, while the patient was receiving itraconazole prophylaxis, right-sided chest pain and fevers developed. A computed tomography (CT) scan showed a 2-cm right middle lobe nodule adjacent to the cardiac border and mediastinal lymphadenopathy abutting the superior vena cava and anterior pericardium (Figure 1). Lymph node biopsy yielded a mold morphologically identified as A. fumigatus. Treatment with voriconazole was initiated. Repeat imaging 1 week later showed slight enlargement of the mediastinal mass. One month later, there was continued enlargement of the lung nodule and mediastinal adenopathy with necrosis. Caspofungin was added. Two weeks later, a new right middle lobe infiltrate was noted. Antifungal therapy was changed to posaconazole. Over the next 2 months, there was expansion of the right lung infiltrates and lymphadenopathy. Treatment was modified to posaconazole and caspofungin. Serial imaging over the next 3 weeks showed regression of the lung consolidations and mediastinal mass. Four months later, with ongoing resolution of the thoracic disease, the patient began receiving a maintenance dosage of posaconazole. As of 5 years later, he had experienced no recurrence.

Bottom Line: Aspergillus viridinutans, a mold phenotypically resembling A. fumigatus, was identified by gene sequence analyses from 2 patients.Disease was distinct from typical aspergillosis, being chronic and spreading in a contiguous manner across anatomical planes.We emphasize the recognition of fumigati-mimetic molds as agents of chronic or refractory aspergillosis.

View Article: PubMed Central - PubMed

Affiliation: National Institutes of Health, Bethesda, Maryland 20892-1684, USA.

ABSTRACT
Aspergillus viridinutans, a mold phenotypically resembling A. fumigatus, was identified by gene sequence analyses from 2 patients. Disease was distinct from typical aspergillosis, being chronic and spreading in a contiguous manner across anatomical planes. We emphasize the recognition of fumigati-mimetic molds as agents of chronic or refractory aspergillosis.

Show MeSH
Related in: MedlinePlus