title: Chaetomium atrobrunneum and Aspergillus fumigatus in multiple tracheal aspirates: Copathogens or symbiosis.
abstract: Chaetomium atrobrunneum has never been reported to be associated with pneumonia. We report the isolation of C. atrobrunneum and Aspergillus fumigatus from a Chinese elderly patient with fatal pneumonia. Branched, long, and septate hyphae were observed in potassium hydroxide preparations and Gram-stained smears, and confluent C. atrobrunneum growth and a few A. fumigatus colonies were found in tracheal aspirates (nine separate occasions). These isolates were identified by conventional morphological methods and by sequencing the internal transcribed spacer and the D1/D2 domain of the 26S rRNA gene. The patient responded poorly to the combination therapy of amphotericin B and caspofungin. This report adds C. atrobrunneum to the list of fungal pneumonia in immunocompromised hosts. This case report also illustrated the presence of a growth symbiosis between Chaetomium species and A. fumigatus.
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: He
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yali
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR-Pathology West, Westmead Hospital, University of Sydney, Westmead, New South Wales, Australia.
authors.forename: Sharon C-A
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Long
authors.affiliation: Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR-Pathology West, Westmead Hospital, University of Sydney, Westmead, New South Wales, Australia.
authors.forename: Fanrong
authors.initials: F
authors.lastname: Kong
authors.affiliation: Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. Electronic address: xycpumch@139.com.
authors.forename: Ying-Chun
authors.initials: YC
authors.lastname: Xu
mesh_terms: D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D012634:Bodily Secretions / Q000382:microbiology; D000077336:Caspofungin; D002597:Chaetomium / Q000302:isolation & purification*; D002681:China; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D054714:Echinocandins / Q000627:therapeutic use; D006801:Humans; D055666:Lipopeptides / Q000627:therapeutic use; D008297:Male; D008828:Microbiological Techniques; D055732:Pulmonary Aspergillosis / Q000188:drug therapy / Q000382:microbiology*; D012335:RNA, Ribosomal / Q000235:genetics; D017422:Sequence Analysis, DNA; D013559:Symbiosis; D014132:Trachea / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer; D054714:Echinocandins; D055666:Lipopeptides; D012335:RNA, Ribosomal; C065096:RNA, ribosomal, 26S; D000666:Amphotericin B; D000077336:Caspofungin