title: Pseudallescheria boydii with Aspergillus fumigatus and Aspergillus terreus in a Critically Ill Hematopoietic Stem Cell Recipient with ARDS.
abstract: Pseudallescheria boydii is a fungal organism known to affect immunocompromised patients. This organism is known to cause, in severe cases, invasive infection of various organs such as the central nervous, cardiovascular, and respiratory systems. We report an unusual case of pulmonary P. boydii pneumonia in an immunocompromised critically ill patient with a co-infection of Aspergillus fumigatus and Aspergillus terreus with ARDS. This case highlights the importance of a high index of suspicion for superimposed fungal infections in patients who are critically ill and immunocompromised. Uncommon fungal pathogens should be considered in the differential diagnosis of respiratory failure, especially if diagnostic markers such as galactomannan (from BAL and serum) or 1,3-beta-D-glucan are elevated. Further diagnostic interventions are warranted when insufficient clinical improvement is observed to prevent treatment failure and adverse outcomes.
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany. Tobias.Lahmer@mri.tum.de.
authors.forename: Tobias
authors.initials: T
authors.lastname: Lahmer
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: Marlena
authors.initials: M
authors.lastname: Messer
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Ehmer
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Eser
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: Analena
authors.initials: A
authors.lastname: Beitz
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: Lisa
authors.initials: L
authors.lastname: Fekecs
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: Roland M
authors.initials: RM
authors.lastname: Schmid
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Huber
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy*; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D017291:Clarithromycin / Q000627:therapeutic use; D060085:Coinfection / Q000188:drug therapy* / Q000382:microbiology; D016638:Critical Illness / Q000628:therapy; D015199:Extracorporeal Membrane Oxygenation; D005690:Galactose / Q000031:analogs & derivatives; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D016867:Immunocompromised Host; D000069349:Linezolid / Q000627:therapeutic use; D008297:Male; D008351:Mannans / Q000097:blood; D000077731:Meropenem; D011014:Pneumonia / Q000188:drug therapy* / Q000382:microbiology; D011541:Pseudallescheria / Q000187:drug effects / Q000302:isolation & purification*; D045169:Severe Acute Respiratory Syndrome / Q000401:mortality / Q000628:therapy; D013845:Thienamycins / Q000627:therapeutic use; D066027:Transplant Recipients; D065819:Voriconazole / Q000627:therapeutic use; D047071:beta-Glucans / Q000097:blood
chemical_list: D000935:Antifungal Agents; D008351:Mannans; D013845:Thienamycins; D047071:beta-Glucans; C012990:galactomannan; D000666:Amphotericin B; C033363:beta-1,3-glucan; D000077731:Meropenem; D017291:Clarithromycin; D000069349:Linezolid; D065819:Voriconazole; D005690:Galactose
keywords: Aspergillus fumigatus; Aspergillus terreus; Critically ill; Pseudallescheria boydii