We report a fatal infection in a 65-year-old immunocompromised male patient caused by pan-triazole-resistant Aspergillus fumigatus containing a TR34/L98H genetic mutation linked to agricultural fungicide use. Clinical and environmental surveillance of triazole-resistant A. fumigatus is needed in the United States to prevent spread and guide healthcare and agricultural practices.
Keywords: Aspergillus fumigatus; Fungi; Pennsylvania; United States; agriculture; antifungal drug resistance; antimicrobial resistance; invasive mold infection; respiratory infections; triazoles.