Pulmonary aspergillosis caused by a pan-azole-resistant Aspergillus fumigatus in a 10-year-old boy.
A 10-year-old boy with high-risk acute lymphoblastic leukemia treated with hematopoietic stem-cell transplantation developed pulmonary aspergillosis while receiving prophylactic voriconazole. A transpleural aspirate culture revealed a pan-azole-resistant Aspergillus fumigatus. Treatment with liposomal amphotericin B resulted in complete recovery. As the frequency of azole resistance in A. fumigatus increases, invasive procedures to isolate fungi for species identification and susceptibility testing becomes even more important.
Department of General Pediatrics, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands. twolfs@umcutrecht.nl
Valtyr S
VS
Thors
Marc B
MB
Bierings
Willem J G
WJ
Melchers
Paul E
PE
Verweij
Tom F W
TF
Wolfs
D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000494:pharmacology*; D001232:Aspergillus fumigatus / Q000187:drug effects* / Q000302:isolation & purification*; D001393:Azoles / Q000008:administration & dosage / Q000494:pharmacology*; D018890:Chemoprevention / Q000379:methods; D002648:Child; D026141:Drug Resistance, Multiple, Fungal; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000628:therapy; D055732:Pulmonary Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D011743:Pyrimidines / Q000008:administration & dosage; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage; D065819:Voriconazole
D000935:Antifungal Agents; D001393:Azoles; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; D000666:Amphotericin B; D065819:Voriconazole