Iterative breakthrough invasive aspergillosis due to TR(34) /L98H azole-resistant Aspergillus fumigatus and Emericella sublata in a single hematopoietic stem cell transplant patient

Transpl Infect Dis. 2014 Aug;16(4):687-91. doi: 10.1111/tid.12231. Epub 2014 May 10.

Abstract

We report 3 consecutive episodes of invasive aspergillosis in a single hematopoietic stem cell transplant patient successively attributed to TR(34) /L98H azole-resistant Aspergillus fumigatus and to a first occurrence of invasive Emericella sublata infection. This case illustrates potential selection of resistant molds during antifungal therapy in hematological patient.

Keywords: Aspergillus fumigatus; Emericella sublata; azole resistance; breakthrough infection; invasive aspergillosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / pharmacology*
  • Antifungal Agents / therapeutic use
  • Aspergillus fumigatus / isolation & purification*
  • Azoles / pharmacology
  • Cytochrome P-450 Enzyme System / genetics
  • DNA, Fungal / genetics
  • Drug Resistance, Fungal
  • Emericella / isolation & purification*
  • Fatal Outcome
  • Female
  • Fungal Proteins / genetics
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Invasive Pulmonary Aspergillosis / drug therapy
  • Invasive Pulmonary Aspergillosis / microbiology*
  • Microbial Sensitivity Tests
  • Promoter Regions, Genetic

Substances

  • Antifungal Agents
  • Azoles
  • DNA, Fungal
  • Fungal Proteins
  • Cytochrome P-450 Enzyme System
  • cytochrome P-450 CYP51A, Aspergillus