Invasive aspergillosis has become one of the serious opportunistic infection in patients with induced immunosuppression. In the paper, a case of pulmonary aspergillosis caused by two different species is described with a detailed histopathological and molecular biological examination. A patient, 68 yearold, male, showed the diffuse interstitial shadow in his both lungs on chest X ray photograph with a progression of respiratory distress after finishing of chemotherapy for his advanced lung cancer in the right lower lobe. Whereas a steroid pulse therapy was carried out, his status was not recovered. He was dead in pulmonary failure. The consequent autopsy study revealed a widespread invasive pulmonary aspergillosis in both lungs. To confirm the diagnosis, in situ hybridization employing three different probes; 18S rRNA gene (panfungal probe), alkaline protease gene (ALP; Aspergillus spp.- specific), and long terminal repeat of Afut1 (retrotransposon; A fumigatus-specific), was carried out on paraffin sections from the lesions of both lungs. Filamentous fungi appeared in the right lesion were positive with both ALP and Afut1, but that from the left indicating characteristics of A. niger confirmed by consequent detailed histological examination exhibited a negative signal with Afut1. Accordingly, the patient was diagnosed as invasive aspergillosis caused by combined infection of A. fumigatus and A. niger.
Full conference title:
14th Annual Focus on Fungal Infections
- FFI 14th (2004)