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Nevez G, Guillerm G, Talarmin JP, Quinio D, Iriart X, Lissillour PL, Rezig S, Fangous MS, Ranty M, Bodenes L, Aubron C, Couturier MA, Le Gal S. Hormographiella aspergillata pulmonary infections: Detection and identification of the fungus using pan-fungal PCR assays and DNA sequencing. J Mycol Med 2024; 34:101463. [PMID: 38342037 DOI: 10.1016/j.mycmed.2024.101463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/13/2024]
Abstract
Hormographiella aspergillata is a basidiomycete exceptionally involved in invasive fungal infections (IFI). We report a case of H. aspergillata pulmonary infection in a 30-year-old female in a context of pancytopenia and relapsed of acute myeloid leukemia (AML). She presented with fever, thoracic pain, left pleural effusion and pneumonia, diagnosed on chest X-ray and CT-scan. Direct examination of a bronchoalveolar lavage (BAL) specimen performed on day (d) 10 was negative, while the culture was positive on d30. H. aspergillata was suspected, considering macroscopic and microscopic examination. Its identification was confirmed using Microflex® Bruker mass spectrometry and pan-fungal (PF)-PCR assay followed by DNA sequencing. After this initial diagnosis, the patient was monitored for 2.8 years. She was treated with liposomal amphotericin B and/or voriconazole until switching to isavuconazole on d298 due to side-effects. This antifungal treatment was maintained until d717 and then discontinued, the patient being considered as cured. Over this follow-up period, the patient was submitted to recurrent pulmonary sampling. Each time, cultures were negative, while PF - PCR assays and DNA sequencing confirmed the presence of H. aspergillata. The present case-report is the 32nd observation of H. aspergillata invasive infection showing that this IFI is still infrequent. Fifteen have occurred in patients with AML, which appears as the most frequent underlying disease favoring this IFI. Six recent case-reports in addition to ours highlight PF-PCR assays and DNA sequencing as relevant diagnostic tools that must be included in routine diagnosis and monitoring of IFI, specifically those due to rare basidiomycetes.
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Affiliation(s)
- Gilles Nevez
- Laboratory of Parasitology and Mycology, Brest University Hospital, F-29609 Brest, France; Fungal Respiratory Infections (FRI) Research Unit, UNIV Angers, UNIV Brest, F-29238 Brest, France.
| | - Gaelle Guillerm
- Hematology, Brest University Hospital, F-29609 Brest, France
| | - Jean-Philippe Talarmin
- Infectious Diseases and Tropical Medicine, Cornouaille Hospital, Quimper, France, F-29000 Quimper, France
| | - Dorothée Quinio
- Laboratory of Parasitology and Mycology, Brest University Hospital, F-29609 Brest, France; Fungal Respiratory Infections (FRI) Research Unit, UNIV Angers, UNIV Brest, F-29238 Brest, France
| | - Xavier Iriart
- Parasitology and Mycology Unit, Toulouse University Hospital, F-31059 Toulouse, France; Toulouse Institute for Infectious and Inflammatory Diseases (UMR "Infinity" Inserm/ CNRS/ Toulouse III University), F-31024 Toulouse, France
| | | | - Schéhérazade Rezig
- Infectious Diseases and Tropical Medicine, Brest University Hospital, F-29609 Brest, France
| | | | - Marion Ranty
- Pneumology, Brest University Hospital, F-29609 Brest, France
| | - Laetitia Bodenes
- Intensive care unit, Brest University Hospital, F-29609 Brest, France
| | - Cécile Aubron
- Intensive care unit, Brest University Hospital, F-29609 Brest, France
| | | | - Solène Le Gal
- Laboratory of Parasitology and Mycology, Brest University Hospital, F-29609 Brest, France; Fungal Respiratory Infections (FRI) Research Unit, UNIV Angers, UNIV Brest, F-29238 Brest, France
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