Aspergillus flavus Brain Abscesses Associated with Hepatic Amebiasis in a Non-neutropenic Man in Senegal

Brun, Sophie; Fekkar, Arnaud; Busse, Antoine; Seilhean, Danielle; Lecsö, Marylin; Adler, Dan; Prodanovic, Hélène; Mazier, Dominique; Datry, A.

doi:10.4269/ajtmh.2009.09-0160

Cited by 10 publications

(6 citation statements)

References 12 publications

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“…While specific pulmonary imaging findings can be suggestive of IA, it has recently been noted that radiologic findings of invasive mold infections among solid organ transplant recipients are more varied than previously thought and CNS IA has no consistent radiographic appearance. 7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Additionally, serum galactomannan, which was negative in our patient, is only 55.6% sensitive and 93.9% specific for IA in liver transplant patients. 28 While our patient was an organ recipient, he had no typical clinical or chest imaging findings of IA, no specific brain imaging findings of IA and a negative serum galactomannan.…”

Section: Discussionmentioning

confidence: 90%

“…Upon performing a PubMed-based literature review dating from 2005 to present, we identified19 previously reported cases of CNS IA in patients with liver disease of any kind (Table 1). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Most patients were male with a median age of 38 (range 12 to 68). Four of the 19 patients never received a transplant, and had severe liver with CSF PCR, while in two cases, diagnosis was inferred from cultures from other sites.…”

Section: Liter Ature Re Vie Wmentioning

confidence: 99%

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Diagnosis of central nervous system invasive aspergillosis in a liver transplant recipient using microbial cell‐free next generation DNA sequencing

Shishido

Vostal

Mayer

et al. 2021

Transplant Infectious Dis

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Invasive aspergillosis (IA) is in an important opportunistic infection affecting transplant patients. 1,2 While all solid organ transplant recipients are at risk for invasive aspergillosis, liver transplant patients appear to be at particularly high risk for disseminated disease and have poor outcomes, with mortality ranging from 64% to 100%. 1,3 For liver transplant recipients, time to onset of IA after transplant is decreased when compared to other organ transplant recipients. 1,3,4 Additionally, liver disease itself, in the absence of a transplant, portends an increased risk for IA. [1][2][3]5,6 Typically, IA is caused by Aspergillus fumigatus and the most frequent manifestation of infection is invasive pulmonary disease. 1 However, disseminated aspergillosis including, intraabdominal, intravascular and neurological involvement is not uncommon. [1][2][3][4]6 While pulmonary IA can be relatively simple to diagnose with use of respiratory samples, serum antigens and imaging, central nervous system (CNS) IA can pose diagnostic challenges which are associated with delayed diagnosis and poor outcomes. 1,3,[5][6][7] Microbial cell-free DNA sequencing (mcfDNA) is a diagnostic modality that has recently shown value as an adjunctive test for the diagnosis of fungal pneumonia in stem-cell transplant patients. 8 When compared to standard diagnostic methods, use of mcfDNA had a 51% sensitivity and 100% specificity. Herein, we present a case demonstrating the utility of this novel diagnostic technique in the diagnosis of fungal brain abscesses in a patient who had recently undergone liver transplantation.

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Section: Discussionmentioning

confidence: 90%

Section: Liter Ature Re Vie Wmentioning

confidence: 99%

Diagnosis of central nervous system invasive aspergillosis in a liver transplant recipient using microbial cell‐free next generation DNA sequencing

Shishido

Vostal

Mayer

et al. 2021

Transplant Infectious Dis

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“…Environment plays an important role in the epidemiology of A. flavus human infection. Infections due to this species are more prevalent in dry and hot climatic regions, and some clinical cases reported in France are imported infections contracted in Africa [24,25,32]. Infections are mostly acquired by exposure to A. flavus spores in the environment, and nosocomial infections in hospitals have also been reported from surgery unit air and surface [30,92].…”

Section: Discussionmentioning

confidence: 99%

“…A. flavus is also the first agent of skull base aspergillosis, whose typical form is malignant external otitis [12][13][14][15][16][17], and the principal risk factor is diabetes [18]. A. flavus could also be implicated in many other clinical forms such as pulmonary invasive aspergillosis [19][20][21][22], chronic rhinosinusitis [23], brain abscesses [24], myositis [25,26], arthritis [27], spondylodiscitis [28,29], endocarditis [30,31], mediastinitis [32], eumycetoma [33], and allergic [34] or hypersensitivity syndromes like hot tub pneumonitis [35].…”

Section: Introductionmentioning

confidence: 99%

The Molecular Identification and Antifungal Susceptibility of Clinical Isolates of Aspergillus Section Flavi from Three French Hospitals

Djenontin,

Costa,

Mousavi

et al. 2023

Microorganisms

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(1) Background: Aspergillus flavus is a cosmopolitan mold with medical, veterinary, and agronomic concerns. Its morphological similarity to other cryptic species of the Flavi section requires molecular identification techniques that are not routinely performed. For clinical isolates of Aspergillus section Flavi, we present the molecular identification, susceptibility to six antifungal agents, and clinical context of source patients. (2) Methods: One hundred forty fungal clinical isolates were included in the study. These isolates, recovered over a 15-year period (2001–2015), were identified based on their morphological characteristics as belonging to section Flavi. After the subculture, sequencing of a part of the β-tubulin and calmodulin genes was performed, and resistance to azole antifungals was screened on agar plates containing itraconazole and voriconazole. Minimum inhibitory concentrations were determined for 120 isolates by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) broth microdilution method. (3) Results: Partial β-tubulin and calmodulin sequences analysis showed that 138/140 isolates were A. flavus sensu stricto, 1 isolate was A. parasiticus/sojae, and 1 was A. nomiae. Many of the isolates came from samples collected in the context of respiratory tract colonization. Among probable or proven aspergillosis, respiratory infections were the most frequent, followed by ENT infections. Antifungal susceptibility testing was available for isolates (n = 120, all A. flavus ss) from one hospital. The MIC range (geometric mean MIC) in mg/L was 0.5–8 (0.77), 0.5–8 (1.03), 0.125–2 (0.25), 0.03–2 (0.22), 0.25–8 (1.91), and 0.03–0.125 (0.061) for voriconazole, isavuconazole, itraconazole, posaconazole, amphotericin B, and caspofungin, respectively. Two (1.67%) isolates showed resistance to isavuconazole according to current EUCAST breakpoints with MICs at 8 mg/L for isavuconazole and voriconazole. One of these two isolates was also resistant to itraconazole with MIC at 2 mg/L. (4) Conclusions: The present characterization of a large collection of Aspergillus belonging to the Flavi section confirmed that A. flavus ss is the predominant species. It is mainly implicated in respiratory and ENT infections. The emergence of resistance highlights the need to perform susceptibility tests on section Flavi isolates.

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“…Neuroaspergillosis is an uncommon infection associated with an exceedingly high mortality. The diagnosis of neuroaspergillosis is difficult, often made at the terminal stage of disease or on autopsy [1]. Perhaps due to the greater penetration into the central nervous system (CNS), voriconazole treatment greatly improved clinical outcomes with a survival rate of 30% in high-risk patients [2,3].…”

mentioning

confidence: 99%

Invasive pulmonary and central nervous system aspergillosis following slops aspiration in a trauma patient

et al. 2010

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Aspergillus flavus Brain Abscesses Associated with Hepatic Amebiasis in a Non-neutropenic Man in Senegal

Cited by 10 publications

References 12 publications

Diagnosis of central nervous system invasive aspergillosis in a liver transplant recipient using microbial cell‐free next generation DNA sequencing

Diagnosis of central nervous system invasive aspergillosis in a liver transplant recipient using microbial cell‐free next generation DNA sequencing

The Molecular Identification and Antifungal Susceptibility of Clinical Isolates of Aspergillus Section Flavi from Three French Hospitals

Invasive pulmonary and central nervous system aspergillosis following slops aspiration in a trauma patient

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