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A fatal case of disseminated aspergillosis caused by a non-sporulating strain of Aspergillus fumigatus
  1. M E Callister1,
  2. M J Griffiths1,
  3. A G Nicholson2,
  4. A Leonard3,
  5. E M Johnson4,
  6. M I Polkey5,
  7. J R Kerr6
  1. 1Department of Critical Care, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, London SW3 6NP, UK
  2. 2Department of Histopathology, Royal Brompton Hospital, National Heart and Lung Institute
  3. 3Department of Respiratory Medicine, Swindon and Marlborough NHS Trust, Swindon SN3 6BB, Wiltshire, UK
  4. 4Mycology Reference Laboratory, Health Protection Agency, Myrtle Road, Kingsdown, Bristol BS2 8EL, UK
  5. 5Department of Respiratory Medicine, Royal Brompton Hospital, National Heart and Lung Institute
  6. 6Department of Microbiology, Royal Brompton Hospital, National Heart and Lung Institute
  1. Correspondence to:
 Dr J R Kerr
 Department of Paediatric Infectious Diseases, St Mary’s Campus, Imperial College London, Norfolk Place, London W2 1PG, UK; j.kerrimperial.ac.uk

Abstract

This report describes the case of a 38 year old pregnant woman with fatal disseminated aspergillosis and multiorgan failure, which was preceded by a long history of allergic bronchopulmonary aspergillosis. Postmortem revealed massive infarction and abscess formation in both lungs. Histology revealed a focal granulomatous response. Fungal infiltration with areas of necrosis were also seen in the liver, spleen, and paratracheal, mediastinal, para-aortic, and hilar lymph nodes. Culture of tissue samples produced a non-sporulating, beige coloured fungus that developed green pigmentation only after three weeks of incubation. Nucleotide sequencing of the D1–D2 region of the large ribosomal subunit revealed 100% homology with Aspergillus fumigatus. Minimum inhibitory concentrations for amphotericin B and itraconazole were both 0.25 mg/litre (susceptible). Further work is urgently required to determine the prevalence of such non-sporulating strains and their relevance to clinical infection.

  • Aspergillus fumigatus
  • aspergillosis
  • non-sporulating
  • non-sporing

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