Aspergillus calidoustus case series and review of the literature

Abstract

Aspergillus calidoustus, previously classified as Aspergillus ustus, is an emerging pathogen in immunocompromised persons. We describe four recent cases of A. calidoustus and review 37 additional cases of A. calidoustus (n = 8) or A. ustus (n = 29) published through June 2016. Twenty (49%) cases occurred in patients with hematologic malignancy and/or receipt of hematopoietic cell transplantation, and 13 (32%) occurred in solid organ transplant recipients. Antifungal susceptibility was reported in 49% of cases and in 42% treatment failed. Overall mortality was 66% and, where reported, attributable mortality was 30%. A. calidoustus infection is associated with a high mortality rate and frequently displays in vitro antifungal resistance.

Cryptic Aspergillus from clinical samples in the USA and description of a new species in section Flavipedes

“…This species was introduced in 2008 based on clinical strains previously identified as A. ustus . Since then, a rising number of infections attributed to A. calidoustus have been reported, which are significantly important because of its elevated MICs for triazoles . Aspergillus granulosus is another species of the section identified in this study, which is responsible for occasional cases of disseminated infection in cardiac transplant recipients, cerebral aspergillosis, and endodontic infections .…”

Aspergillus pseudodeflectus: a new human pathogen in liver transplant patients

“…Molecular identification is recommended to avoid false identifications because species within a single section cannot be morphologically [39] distinguished from each other [12] . Previous cases of IA caused by A. ustus were misidentified [21], mostly as A. calidoustus [40]. The latter was included as a new species in 2008, and ever since it has been the most commonly reported cause of IA in this section [21].…”

Make Sure You Have a Safety Net: Updates in the Prevention and Management of Infectious Complications in Stem Cell Transplant Recipients

“…This species, Aspergillus calidoustus, exhibits high in vitro minimum inhibitory concentrations to multiple antifungal agents, including amphotericin B and voriconazole. In one case, serial combination antifungal therapy was ineffective and infection was universally fatal [66].…”