Fatal bronchial invasion of Scopulariopsis brevicaulis in an acute monocytic leukemia patient.
A case of fatal invasion of Scopulariopsis brevicaulis to the bronchus in an acute monocytic leukemia (M(5)) patient is described. This infection leads to mediastinal emphysema, bronchial bleeding, and bronchial obstruction before finally spreading to the entire lung. The patient was initially diagnosed with pulmonary aspergillosis based on clinical signs and morphological examination. However, S. brevicaulis was finally identified by 18S rDNA sequencing. The patient failed lipid amphotericin B therapy and voriconazole plus caspofungin combination therapy. To the best of our knowledge, this is the first report on S. brevicaulis affecting the bronchus and resulting in a fatal prognosis in an M(5) patient.
State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, PR China.
Qing
Q
Yang
Juying
J
Wei
Zhenjing
Z
Chen
D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage; D001980:Bronchi / Q000382:microbiology*; D000077336:Caspofungin; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D004359:Drug Therapy, Combination / Q000379:methods; D054714:Echinocandins / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D020459:Genes, rRNA; D006651:Histocytochemistry; D006801:Humans; D007948:Leukemia, Monocytic, Acute / Q000150:complications*; D055666:Lipopeptides; D008168:Lung / Q000382:microbiology / Q000473:pathology; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000382:microbiology*; D008969:Molecular Sequence Data; D011743:Pyrimidines / Q000008:administration & dosage; D012331:RNA, Fungal / Q000235:genetics; D012337:RNA, Ribosomal, 18S / Q000235:genetics; D013902:Radiography, Thoracic; D060645:Scopulariopsis / Q000302:isolation & purification*; D017422:Sequence Analysis, DNA; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D014230:Triazoles / Q000008:administration & dosage; D065819:Voriconazole
D004271:DNA, Fungal; D004275:DNA, Ribosomal; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D012331:RNA, Fungal; D012337:RNA, Ribosomal, 18S; D014230:Triazoles; D000666:Amphotericin B; D000077336:Caspofungin; D065819:Voriconazole