Fatal invasive pulmonary aspergillosis caused by voriconazole-resistant Aspergillus tubingensis in a patient with solid tumor

Sohei Harada; Daisuke Ohkushi; Kenji Nakano; Hiroki Mitani; Yutaka Yamamoto; Katsuhiko Kamei; Brian Hayama

doi:10.1016/j.jiac.2019.10.022

Fatal invasive pulmonary aspergillosis caused by voriconazole-resistant Aspergillus tubingensis in a patient with solid tumor

J Infect Chemother. 2020 Mar;26(3):301-304. doi: 10.1016/j.jiac.2019.10.022. Epub 2019 Nov 29.

Authors

Sohei Harada¹, Daisuke Ohkushi², Kenji Nakano³, Hiroki Mitani⁴, Yutaka Yamamoto⁵, Katsuhiko Kamei⁶, Brian Hayama²

Affiliations

¹ Department of Infectious Diseases, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan; Department of Infectious Diseases, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. Electronic address: haradas-tky@umin.ac.jp.
² Department of Infectious Diseases, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
³ Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
⁴ Department of Head and Neck Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
⁵ Department of Intensive Care, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
⁶ Division of Infectious Diseases, Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba, 260-8670, Japan.

PMID: 31787529
DOI: 10.1016/j.jiac.2019.10.022

Abstract

We report a fatal case of invasive pulmonary aspergillosis caused by voriconazole-resistant Aspergillus tubingensis in a patient with solid tumor but without severe immunosuppression. A high index of suspicion for invasive pulmonary aspergillosis, coupled with molecular identification of species and resistance genes, may facilitate early initiation of appropriate treatment.

Keywords: Aspergillus tubingensis; Invasive aspergillosis; Solid tumor; Voriconazole resistance.

Publication types

Case Reports

MeSH terms

Antifungal Agents / pharmacology
Antifungal Agents / therapeutic use
Aspergillus / drug effects*
Drug Resistance, Fungal*
Fatal Outcome
Humans
Invasive Pulmonary Aspergillosis*
Lung / diagnostic imaging
Lung / pathology
Male
Middle Aged
Tongue Neoplasms / complications*
Voriconazole / pharmacology*

Substances

Antifungal Agents
Voriconazole