The lung infection is the major problem faced by CF patients. The bacterial level, colonization by Staphylococcus aureus , Haemophilus influenzae and / or Pseudomonas aeruginosa is generally initially observed, accelerating the deterioration of the pulmonary function. Fungal colonization is frequent in cystic fibrosis and is dominated byAspergillus fumigatus, Scedosporium apiospermum, Exophiala dermatitidis . Recently other filamentous fungi have been isolated from bronchial secretions in the case of Geosmithia argillacea .
In this observation we report the case of a child aged 11 years with cystic fibrosis, the discovery of his disease took place at birth, it carries a homozygous F508 mutation of CFTR (Cystic Fibrosis Transmembrane Conductance Regulator), it was usually colonized by S. aureus and occasionally by Aspergillus fumigatus .
On the occasion of a cytobacteriological sputum (ECBC) made in the follow-up to his illness he was found on medium Sabouraud a filamentous fungus that has a slow and restricted cultivation at room temperature but more abundant at 37 . It grows in the presence or absence of actidione.
The macroscopic appearance shows fluffy powdery colonies of beige color cream 2 to 3 cm in diameter after 7 days of incubation.
Microscopic examination showed the presence of septate conidiophores often connected that branch in whorls with sharply pointed phialides. Conidia are hyaline cylindrical or ellipsoidal.
The identification of the fungus was confirmed by molecular biology (Parasitology-Mycology UF CHU d'Angers), it is Geosmithia argillacea.
Geosmithia argillacea is an emerging pathogen in CF patients.
Moreover, it seems that the colonization of these patients by this fungus has no particular clinical relevance, though it can play a decisive role in case of immunosuppression as was described with Aspergillus fumigatus andScedosporium apiospermum that can give very serious often fatal invasive infections.
Full conference title:
- RICAI 31st (2011)