Abstract
A fatal case of a pulmonary infection caused by Hormographiella aspergillata, the anamorph of the mushroom Coprinus cinereus, is reported for a patient receiving treatment for a second relapse of acute lymphoblastic leukemia. The filamentous basidiomycete was identified with restriction fragment length polymorphism patterns of PCR-amplified internally transcribed spacers and small subunit ribosomal DNA with four restriction enzymes. The patient failed to respond to treatment with amphotericin B and itraconazole. The fungus was cultured from the lungs at autopsy: the MIC of amphotericin B for the fungus was low (0.5 mg/liter), and that of itraconazole was high (8 mg/liter).
MeSH terms
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Adult
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Amphotericin B / pharmacology
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Bronchi / microbiology
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Bronchi / pathology
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Coprinus / drug effects
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Coprinus / genetics
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Coprinus / isolation & purification
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Coprinus / pathogenicity*
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DNA, Ribosomal / genetics
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Humans
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Lung / microbiology
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Lung / pathology
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Lung Diseases, Fungal / complications
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Lung Diseases, Fungal / diagnosis*
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Lung Diseases, Fungal / drug therapy
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Lung Diseases, Fungal / mortality
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Male
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Microbial Sensitivity Tests
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Polymerase Chain Reaction
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
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RNA, Ribosomal / genetics
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Recurrence
Substances
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DNA, Ribosomal
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RNA, Ribosomal
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Amphotericin B