Post-influenzal triazole-resistant aspergillosis following allogeneic stem cell transplantation

Mycoses. 2018 Aug;61(8):570-575. doi: 10.1111/myc.12770. Epub 2018 Jun 11.

Abstract

Influenza virus infection is now recognised as a risk factor for invasive pulmonary aspergillosis (IPA). Delays in diagnosis contribute to delayed commencement of antifungal therapy. In addition, the emergence of resistance to first-line triazole antifungal agents puts emphasis on early detection to prevent adverse outcomes. We present 2 allogeneic stem cell transplant patients who developed IPA due to triazole-resistant Aspergillus fumigatus following influenza infection. We underline the challenges faced in the management of these cases, the importance of early diagnosis and need for surveillance given the emergence of triazole resistance.

Keywords: influenza; invasive pulmonary aspergillosis; stem cell transplant; triazole resistance.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / pharmacology*
  • Aspergillus fumigatus / drug effects*
  • Aspergillus fumigatus / isolation & purification
  • Drug Resistance, Fungal*
  • Humans
  • Influenza, Human / complications*
  • Invasive Pulmonary Aspergillosis / diagnosis*
  • Invasive Pulmonary Aspergillosis / microbiology
  • Male
  • Middle Aged
  • Stem Cell Transplantation / adverse effects
  • Transplantation, Homologous / adverse effects
  • Triazoles / pharmacology*

Substances

  • Antifungal Agents
  • Triazoles