Invasive pulmonary aspergillosis due to azole‐resistant Aspergillus lentulus

Clinical and Microbiological Characterization of Invasive Pulmonary Aspergillosis Caused by Aspergillus lentulus in China

“…More importantly, poor clinical outcome has been associated with azole therapy administered to patients with IPA caused by A. lentulus (Yoshida et al, 2015;Tetsuka et al, 2017). Tetsuka et al (2017) chose micafungin to cure A. lentulus infection after no clinical response was observed with voriconazole use. Of note, even though all A. lentulus isolates in our study were susceptible to echinocandins in vitro, two patients died after receiving caspofungin treatment.…”

“…However, A. lentulus has generally proven to possess evaluated MIC values to voriconazole and other azoles ( Balajee et al, 2004 , 2009 ; Montenegro et al, 2009 ; Symoens et al, 2010 ; Zbinden et al, 2012 ; Bastos et al, 2015 ; Tamiya et al, 2015 ; Won et al, 2018 ). More importantly, poor clinical outcome has been associated with azole therapy administered to patients with IPA caused by A. lentulus ( Yoshida et al, 2015 ; Tetsuka et al, 2017 ). Tetsuka et al (2017) chose micafungin to cure A. lentulus infection after no clinical response was observed with voriconazole use.…”

“…including A. flavus , A. terreus , and A. niger and cryptic species within the A. fumigatus complex have been increasingly recognized ( Gurcan et al, 2013 ; Sugui et al, 2014 ). Of the last, in particular Aspergillus lentulus has become a significant pathogen in many countries including America, Spain, Argentina, Denmark, France, Germany, Turkey, Switzerland, Brazil, Japan, Australia, and Korea ( Balajee et al, 2004 , 2005a , 2009 ; Alcazar-Fuoli et al, 2008 ; Montenegro et al, 2009 ; Symoens et al, 2010 ; Mortensen et al, 2011 ; Zbinden et al, 2012 ; Datta et al, 2013 ; Escribano et al, 2013 ; Gurcan et al, 2013 ; Alastruey-Izquierdo et al, 2014 ; Lago et al, 2014 ; Bastos et al, 2015 ; Kidd et al, 2015 ; Tamiya et al, 2015 ; Yoshida et al, 2015 ; Tetsuka et al, 2017 ; Won et al, 2018 ).…”

Aspergillus lentulus: An Under-recognized Cause of Antifungal Drug-Resistant Aspergillosis

“…The majority of cases have been reported in transplant patients and people with other immunocompromising states, including receipt of systemic corticosteroids [ 5 , 10 , 12 , 13 , 17 , 19 , 20 , 30 , 31 ]. A review of 6 cases from China reported immunocompromise, critical illness, and prior antifungals to be risks for invasive A. lentulus infections [ 15 ].…”

“…Reports suggest worse outcomes in patients with mixed Aspergillus infections [ 10 , 19 , 30 ]. Similar to other species, A. lentulus causes diverse radiographic findings, including consolidations [ 5 , 12 , 13 , 19 , 20 ], cavitary lesions [ 5 , 12 , 31 ], and nodules [ 19 ].…”