Invasive aspergillosis is a highly lethal opportunistic infection that poses a significant threat to immunocompromised patients. With studies suggesting that the incidence of this disease is increasing, and mortality rates remain high, early diagnosis and treatment are very important to improve patient survival. We present a case of a 63-year-old woman on an immunosuppression regimen with methylprednisolone and azathioprine for the treatment of autoimmune hepatitis, who presented with neurological and respiratory symptoms leading to a rapid clinical decline. A final diagnosis of disseminated invasive aspergillosis was made at autopsy. This case emphasises the importance in maintaining a high index of suspicion to ensure that the proper workup, diagnosis and treatment can be initiated earlier in the clinical presentation in an effort to decrease the extremely high mortality in these cases.
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http://dx.doi.org/10.1136/bcr-2014-204642 | DOI Listing |
Virulence
December 2025
Manchester Fungal Infection Group (MFIG), Division of Evolution, Infection, and Genomics, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Sulfur metabolism is an essential aspect of fungal physiology and pathogenicity. Fungal sulfur metabolism comprises anabolic and catabolic routes that are not well conserved in mammals, therefore is considered a promising source of prospective novel antifungal targets. To gain insight into sulfur-related metabolism during infection, we used a NanoString custom nCounter-TagSet and compared the expression of 68 key metabolic genes in different murine models of invasive pulmonary aspergillosis, at 3 time-points, and under a variety of conditions.
View Article and Find Full Text PDFBMC Infect Dis
January 2025
Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai, Fengtai District, Beijing, 100069, China.
Background: Invasive pulmonary aspergillosis (IPA) is a common opportunistic infection in patients with severe liver disease (SLD), which increases the mortality of patients. The aim of this study was to evaluate the efficacy and safety of voriconazole for IPA in patients with SLD and explore an optimal antifungal regimen.
Methods: This was a retrospective cohort study of SLD patients diagnosed with proven or probable IPA at Beijing Youan Hospital, Capital Medical University between January 1, 2012 to January 31, 2023.
J Clin Microbiol
January 2025
Department of Medicine, Weill Cornell Medical College, New York, New York, USA.
Invasive pulmonary infections are a significant cause of morbidity and mortality in patients with hematological malignancies and hematopoietic stem cell transplantation (HCT) recipients. A delay in identifying a causative agent may result in late initiation of appropriate treatment and adverse clinical outcomes. We examine the diagnostic utility of PCR-based assays in evaluating invasive pulmonary infections from bronchoalveolar lavage (BAL).
View Article and Find Full Text PDFSci Rep
January 2025
Department of Anesthesiology, Medical Faculty, Heidelberg University, 69120, Heidelberg, Germany.
Invasive infections with Aspergillus fumigatus in ICU patients are linked to high morbidity and mortality. Diagnosing invasive pulmonary aspergillosis (IPA) in non-immunosuppressed patients is difficult, as Aspergillus antigen (galactomannan [GM]) may have other causes. This retrospective study analyzed 160 ICU surgical patients with positive GM in broncho-alveolar lavage fluid (BALF), classifying them based on AspICU criteria for suspected IPA (pIPA) or aspiration.
View Article and Find Full Text PDFRespir Med Case Rep
December 2024
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
Hyperimmunoglobulin E syndrome (HIGES) is a rare immunodeficiency characterized by high levels of immunoglobulin E (IgE) in the setting of various clinical features such as cutaneous candidiasis, asthma, recurrent rashes, and fungal infections. This case describes a 70-year-old male with cachexia and dyspnea found to have a cavitary lesion and aspergilloma, with remarkably high IgE and positive 1,3-β-D-glucan and Aspergillus testing. Herein, we describe the aforementioned case, review the available literature, and hypothesize the connection between invasive fungal infections and HIGES.
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