title: A case of bronchial aspergillosis caused by Aspergillus udagawae and its mycological features.
abstract: Aspergillus udagawae and A. fumigatus share similar morphological features but they differ genetically. There is also an important clinical distinction as A. udagawae is less sensitive to amphotericin B than A. fumigatus. We encountered a rare case of bronchial infection due to A. udagawae that was successfully treated with voriconazole. An 82-year-old woman with diabetes mellitus complained of bloody sputum. Bronchoscopy revealed a white plugged region at the origin of the right bronchi B5. Cytological study revealed a clot composed of filamentous fungi and Aspergillus spp. was detected by culture. Molecular analysis revealed that the causative agent was A. udagawae, and voriconazole was used for the treatment. In comparison to A. fumigatus, the A. udagawae strain isolated in this case was less sensitive to amphotericin B, less virulent in immunosuppressed mice, and more sensitive to hydrogen peroxide, features that are almost identical to those of the previously reported isolates of the fungus. We should be aware of the emergence of new Aspergillus species that might pose a clinical threat.
authors.affiliation: Internal Medicine, Goto Central Hospital, Goto, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Gyotoku
authors.forename: Koichi
authors.initials: K
authors.lastname: Izumikawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Ikeda
authors.forename: Takahiro
authors.initials: T
authors.lastname: Takazono
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Morinaga
authors.forename: Shigeki
authors.initials: S
authors.lastname: Nakamura
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Imamura
authors.forename: Tomoya
authors.initials: T
authors.lastname: Nishino
authors.forename: Taiga
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kakeya
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yanagihara
authors.forename: Akira
authors.initials: A
authors.lastname: Yasuoka
authors.forename: Takashi
authors.initials: T
authors.lastname: Yaguchi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ohno
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Miyzaki
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kamei
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kanda
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000369:Aged, 80 and over; D000818:Animals; D001228:Aspergillosis / Q000188:drug therapy / Q000382:microbiology*; D001230:Aspergillus / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity; D001982:Bronchial Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D001999:Bronchoscopy / Q000379:methods; D003920:Diabetes Mellitus / Q000473:pathology; D005260:Female; D006801:Humans; D006861:Hydrogen Peroxide / Q000494:pharmacology; D016867:Immunocompromised Host; D008168:Lung / Q000382:microbiology / Q000473:pathology; D051379:Mice; D011743:Pyrimidines / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D011743:Pyrimidines; D014230:Triazoles; D006861:Hydrogen Peroxide; D065819:Voriconazole