Maxime Moniot1,2, Rose-Anne Lavergne3, Thomas Morel4, Romain Guieze5, Florent Morio3, Philippe Poirier4,6, Céline Nourrisson4,6. 1. Laboratoire de Parasitologie-Mycologie, CHU Clermont-Ferrand, CHU Gabriel Montpied, 58 rue Montalembert, 3IHP, 63003, Clermont-Ferrand Cedex 1, France. mmoniot@chu-clermontferrand.fr. 2. Equipe Interactions Hôte-Parasite, Laboratoire Microorganismes : Génome et Environnement, CNRS, Université Clermont-Auvergne, Clermont-Ferrand, France. mmoniot@chu-clermontferrand.fr. 3. Laboratoire de Parasitologie-Mycologie, Département de Mycologie Médicale, Hôpitaux Universitaires de Nantes, Universités Nantes Atlantique, EA1155-IICiMed, Institut de Recherche en Santé 2, Nantes, France. 4. Laboratoire de Parasitologie-Mycologie, CHU Clermont-Ferrand, CHU Gabriel Montpied, 58 rue Montalembert, 3IHP, 63003, Clermont-Ferrand Cedex 1, France. 5. Service d'Hématologie Clinique, CHU Clermont-Ferrand, Clermont-Ferrand, France. 6. Equipe Interactions Hôte-Parasite, Laboratoire Microorganismes : Génome et Environnement, CNRS, Université Clermont-Auvergne, Clermont-Ferrand, France.
Abstract
BACKGROUND: Filamentous basidiomycetes are mainly considered to be respiratory tract colonizers but the clinical significance of their isolation in a specimen is debatable. Hormographiella aspergillata was first reported as a human pathogen in 1971. We discuss the role of this mold as a pathogen or colonizer and give an update on diagnostic tools and in vitro antifungal susceptibility. CASE PRESENTATION: We identified three cases of H. aspergillata with respiratory symptoms in a short period of time. One invasive infection and two colonizations were diagnosed. Culture supernatants showed that H. aspergillata can produce galactomannan and β-D-glucan but not glucuronoxylomannan. For the first time, isavuconazole susceptibility was determined and high minimum inhibitory concentrations (MICs) were found. Liposomal amphotericin B and voriconazole have the lowest MICs. CONCLUSION: To date, 22 invasive infections involving H. aspergillata have been reported. On isolation of H. aspergillata, its pathogenic potential in clinical settings can be tricky. Molecular identification and antifungal susceptibility testing are essential considering high resistance against several antifungal therapies.
BACKGROUND:Filamentous basidiomycetes are mainly considered to be respiratory tract colonizers but the clinical significance of their isolation in a specimen is debatable. Hormographiella aspergillata was first reported as a human pathogen in 1971. We discuss the role of this mold as a pathogen or colonizer and give an update on diagnostic tools and in vitro antifungal susceptibility. CASE PRESENTATION: We identified three cases of H. aspergillata with respiratory symptoms in a short period of time. One invasive infection and two colonizations were diagnosed. Culture supernatants showed that H. aspergillata can produce galactomannan and β-D-glucan but not glucuronoxylomannan. For the first time, isavuconazole susceptibility was determined and high minimum inhibitory concentrations (MICs) were found. Liposomal amphotericin B and voriconazole have the lowest MICs. CONCLUSION: To date, 22 invasive infections involving H. aspergillata have been reported. On isolation of H. aspergillata, its pathogenic potential in clinical settings can be tricky. Molecular identification and antifungal susceptibility testing are essential considering high resistance against several antifungal therapies.