PMID- 35330308
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220329
IS  - 2309-608X (Electronic)
IS  - 2309-608X (Linking)
VI  - 8
IP  - 3
DP  - 2022 Mar 16
TI  - Exclusion of Mucorales Co-Infection in a Patient with Aspergillus flavus 
      Sinusitis by Fluorescence In Situ Hybridization (FISH).
LID - 10.3390/jof8030306 [doi]
LID - 306
AB  - Invasive fungal infections are associated with increased mortality in 
      hematological patients. Despite considerable advances in antifungal therapy, the 
      evaluation of suspected treatment failure is a common clinical challenge 
      requiring extensive diagnostic testing to rule out potential causes, such as 
      mixed infections. We present a 64-year-old patient with secondary AML, diabetes 
      mellitus, febrile neutropenia, and sinusitis. While cultures from nasal tissue 
      grew Aspergillus flavus, a microscopic examination of the tissue was suggestive 
      of concomitant mucormycosis. However, fluorescence in situ hybridization (FISH) 
      using specific probes targeting Aspergillus and Mucorales species ruled out mixed 
      infection. This was confirmed by specific qPCR assays amplifying the DNA of 
      Aspergillus, but not of Mucorales. These results provided a rational basis for 
      step-down targeted therapy, i.e., the patient received posaconazole after seven 
      days of calculated dual therapy with liposomal amphotericin B and posaconazole. 
      Despite clinical response to the antifungal therapy, he died due to the 
      progression of the underlying disease within two weeks after diagnosis of fungal 
      infection. Molecular diagnostics applied to tissue blocks may reveal useful 
      information on the etiology of invasive fungal infections, including challenging 
      situations, such as with mixed infections. A thorough understanding of fungal 
      etiology facilitates targeted therapy that may improve therapeutic success while 
      limiting side effects.
FAU - Kessel, Johanna
AU  - Kessel J
AD  - Department of Internal Medicine, Infectious Diseases, University Hospital 
      Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany.
FAU - Hogardt, Michael
AU  - Hogardt M
AUID- ORCID: 0000-0002-0742-950X
AD  - Institute for Medical Microbiology and Infection Control, University Hospital 
      Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany.
FAU - Aspacher, Lukas
AU  - Aspacher L
AD  - Department of Internal Medicine, Hematology/Oncology, University Hospital 
      Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany.
FAU - Wichelhaus, Thomas A
AU  - Wichelhaus TA
AD  - Institute for Medical Microbiology and Infection Control, University Hospital 
      Frankfurt, Goethe University, 60590 Frankfurt am Main, Germany.
FAU - Gerkrath, Jasmin
AU  - Gerkrath J
AD  - Robert Koch Institute Berlin, FG16, Seestrasse 10, 13353 Berlin, Germany.
AD  - Medizinische Klinik und Poliklinik II, Universitatsklinikum Wurzburg, 97080 
      Wuerzburg, Germany.
FAU - Rosenow, Emely
AU  - Rosenow E
AD  - Robert Koch Institute Berlin, FG16, Seestrasse 10, 13353 Berlin, Germany.
FAU - Springer, Jan
AU  - Springer J
AD  - Medizinische Klinik und Poliklinik II, Universitatsklinikum Wurzburg, 97080 
      Wuerzburg, Germany.
FAU - Rickerts, Volker
AU  - Rickerts V
AUID- ORCID: 0000-0002-6154-4920
AD  - Robert Koch Institute Berlin, FG16, Seestrasse 10, 13353 Berlin, Germany.
LA  - eng
PT  - Case Reports
DEP - 20220316
PL  - Switzerland
TA  - J Fungi (Basel)
JT  - Journal of fungi (Basel, Switzerland)
JID - 101671827
PMC - PMC8955397
OTO - NOTNLM
OT  - Aspergillus
OT  - fluorescence in situ hybridization (FISH)
OT  - fungal sinusitis
OT  - invasive fungal infection
OT  - mixed infection
COIS- The authors declare no conflict of interest.
EDAT- 2022/03/26 06:00
MHDA- 2022/03/26 06:01
PMCR- 2022/03/16
CRDT- 2022/03/25 01:12
PHST- 2022/02/22 00:00 [received]
PHST- 2022/03/10 00:00 [revised]
PHST- 2022/03/14 00:00 [accepted]
PHST- 2022/03/25 01:12 [entrez]
PHST- 2022/03/26 06:00 [pubmed]
PHST- 2022/03/26 06:01 [medline]
PHST- 2022/03/16 00:00 [pmc-release]
AID - jof8030306 [pii]
AID - jof-08-00306 [pii]
AID - 10.3390/jof8030306 [doi]
PST - epublish
SO  - J Fungi (Basel). 2022 Mar 16;8(3):306. doi: 10.3390/jof8030306.