Species

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Domestic crossbred cat with disseminated aspergillosis. KOH preparation of material obtained from thoracotomy of a 3 year old domestic crossbred cat with invasive Aspergillus fumigatus infection. The cat had marked enlargement of the hilar lymph node Domestic crossbred cat with disseminated aspergillosis. KOH preparation of material obtained from thoracotomy of a 3 year old domestic crossbred cat with invasive Aspergillus fumigatus infection. The cat had marked enlargement of the hilar lymph read more...
Domestic crossbred cat with disseminated aspergillosis. KOH preparation of material obtained from thoracotomy of a 3 year old domestic crossbred cat with invasive Aspergillus fumigatus infection. The cat had marked enlargement of the hilar lymph node Domestic crossbred cat with disseminated aspergillosis. KOH preparation of material obtained from thoracotomy of a 3 year old domestic crossbred cat with invasive Aspergillus fumigatus infection. The cat had marked enlargement of the hilar lymph read more...
English Pointer with nasal aspergillosis. Gram stained cytological smear of material obtained from the frontal sinus of a 7 year old English Pointer with nasal aspergillosis. This infection was caused by Aspergillus fumigatus. Magnification x 200. English Pointer with nasal aspergillosis. Gram stained cytological smear of material obtained from the frontal sinus of a 7 year old English Pointer with nasal aspergillosis. This infection was caused by Aspergillus fumigatus. Magnification x 200.
English Pointer with nasal aspergillosis. Gram stained cytological smear of material obtained from the frontal sinus of a 7 year old English Pointer with nasal aspergillosis. This infection was caused by Aspergillus fumigatus. Magnification x 200. English Pointer with nasal aspergillosis. Gram stained cytological smear of material obtained from the frontal sinus of a 7 year old English Pointer with nasal aspergillosis. This infection was caused by Aspergillus fumigatus. Magnification x 200.
Agar dilution - comparing amphotericin B and itraconazole Six isolates of A.fumigatus, of which one (AF72) is documented to be itraconazole resistant. On the left is the control plate, showing good growth at 48 hr on Sabouraud dextrose agar. The next three pairs of plates contain increasing and equal read more...
Agar dilution - comparing amphotericin B and itraconazole Six isolates of A.fumigatus, of which one (AF72) is documented to be itraconazole resistant. On the left is the control plate, showing good growth at 48 hr on Sabouraud dextrose agar. The next three pairs of plates contain increasing and equal read more...
Microbroth dilution of A.fumigatus against itraconazole Microbroth dilution of A.fumigatus against itraconazole. The rows at the top show complete inhibition (susceptible) and the centre row shows no inhibition at all (resistant). An MIC of 4 mg/l (2 clear wells to the right) is shown for the bottom row read more...
Microbroth dilution of A.fumigatus against itraconazole Microbroth dilution of A.fumigatus against itraconazole. The rows at the top show complete inhibition (susceptible) and the centre row shows no inhibition at all (resistant). An MIC of 4 mg/l (2 clear wells to the right) is shown for the bottom row read more...
Aspergillus fumigatus
Aspergillus fumigatus

Colonies on CYA 40-60 mm diam, plane or lightly wrinkled, low, dense and velutinous or with a sparse, floccose overgrowth; mycelium inconspicuous, white; conidial heads borne in a continuous, densely packed layer, Greyish Turquoise to Dark Turquoise (24-25E-F5); clear exudate sometimes produced in small amounts; reverse pale or greenish. Colonies on MEA 40-60 mm diam, similar to those on CYA but less dense and with conidia in duller colours (24-25E-F3); reverse uncoloured or greyish. Colonies on G25N less than 10 mm diam, sometimes only germination, of white mycelium. No growth at 5°C. At 37°C, colonies covering the available area, i.e. a whole Petri dish in 2 days from a single point inoculum, of similar appearance to those on CYA at 25°C, but with conidial columns longer and conidia darker, greenish grey to pure grey.

Conidiophores borne from surface hyphae, stipes 200-400 µm long, sometimes sinuous, with colourless, thin, smooth walls, enlarging gradually into pyriform vesicles; vesicles 20-30 µm diam, fertile over half or more of the enlarged area, bearing phialides only, the lateral ones characteristically bent so that the tips are approximately parallel to the stipe axis; phialides crowded, 6-8 µm long; conidia spherical to subspheroidal, 2.5-3.0 µm diam, with finely roughened or spinose walls, forming radiate heads at first, then well defined columns of conidia.

Distinctive features

This distinctive species can be recognised in the unopened Petri dish by its broad, velutinous, bluish colonies bearing characteristic, well defined columns of conidia. Growth at 37°C is exceptionally rapid. Conidial heads are also diagnostic: pyriform vesicles bear crowded phialides which bend to be roughly parallel to the stipe axis. Care should be exercised in handling cultures of this species.

Fatal haemoptysis post lung-transplant Fig2b (enlargement of Fig 2) Left main bronchus Fig2b (enlargement of fig 2) Left main bronchus
Fig2b (enlargement of fig 2) Left main bronchus Fatal haemoptysis post lung-transplant Fig2b (enlargement of Fig 2) Left main bronchus

Fig 1. Trachea and bronchi A 50+ year old woman received a double lung transplant for emphysema. She did well initially, but then Aspergillus fumigatus was grown from her airways, in association with mucous and a pseudomembrane covering parts of her anastomosis and airways. 2 months after her transplant she was undergoing bronchoscopy, and started to bleed. This rapidly became torrential and she suffered a cardiac arrest and died.

She underwent autopsy at which it was found that the larynx, trachea and major bronchi all contained blood (Fig 1).

The bronchial anastomoses were intact, but brown fluffy material was found overlying the stitches on both sides. On the right side plaques of similar material were seen distal to the anastomoses, overlying an ulcer and an obstructing the smaller bronchi.

On the left side an ulcer 1.5cm in diameter (with blood in it) was seen in the main bronchus distal to the anastomosis on the anterior wall (Fig 2). The sutures of the anastomosis are intact. The centre of the ulcer had ulcerated through into the left main pulmonary artery (Fig 3). The pulmonary artery shows necrosis and discolouration of the intimal surface over an area of 1.5-1.0cm.

Histopathology examination showed fungal hyphae perforating the bronchial wall and arterial wall around and in the ulcer. The ulcer on the right side showed hyphae perforating the wall and bronchial cartilage.

Double diffusion test for aspergillosis Double diffusion test for aspergillosis. Central well contains Aspergillus fumigatus antigen and wells in the top and bottom contain control antiserum.
Double diffusion test for aspergillosis Double diffusion test for aspergillosis. Central well contains Aspergillus fumigatus antigen and wells in the top and bottom contain control antiserum.

 The three peripherals wells with precipitin bands contain sera from patients with A. fumigatus fungus ball (FB). More bands present in the upper right cases is characteristic of FB. The well in the bottom left position is negative.

Conidiophores of Aspergillus fumigatus in the mass. Conidiophores of Aspergillus fumigatus in the mass of the fungal ball surrounded by mycelia (H&E, x 400).
Conidiophores of Aspergillus fumigatus in the mass. Conidiophores of Aspergillus fumigatus in the mass of the fungal ball surrounded by mycelia (H&E, x 400).
Aspergillus fumigatus Fresen Aspergillus fumigatus Fresen
Aspergillus fumigatus Fresen Aspergillus fumigatus Fresen

Colonies on CYA 40-60 mm diam, plane or lightly wrinkled, low, dense and velutinous or with a sparse, floccose overgrowth; mycelium inconspicuous, white; conidial heads borne in a continuous, densely packed layer, Greyish Turquoise to Dark Turquoise (24-25E-F5); clear exudate sometimes produced in small amounts; reverse pale or greenish. Colonies on MEA 40-60 mm diam, similar to those on CYA but less dense and with conidia in duller colours (24-25E-F3); reverse uncoloured or greyish. Colonies on G25N less than 10 mm diam, sometimes only germination, of white mycelium. No growth at 5°C. At 37°C, colonies covering the available area, i.e. a whole Petri dish in 2 days from a single point inoculum, of similar appearance to those on CYA at 25°C, but with conidial columns longer and conidia darker, greenish grey to pure grey.

Conidiophores borne from surface hyphae, stipes 200-400 µm long, sometimes sinuous, with colourless, thin, smooth walls, enlarging gradually into pyriform vesicles; vesicles 20-30 µm diam, fertile over half or more of the enlarged area, bearing phialides only, the lateral ones characteristically bent so that the tips are approximately parallel to the stipe axis; phialides crowded, 6-8 µm long; conidia spherical to subspheroidal, 2.5-3.0 µm diam, with finely roughened or spinose walls, forming radiate heads at first, then well defined columns of conidia.

Distinctive features

This distinctive species can be recognised in the unopened Petri dish by its broad, velutinous, bluish colonies bearing characteristic, well defined columns of conidia. Growth at 37°C is exceptionally rapid. Conidial heads are also diagnostic: pyriform vesicles bear crowded phialides which bend to be roughly parallel to the stipe axis. Care should be exercised in handling cultures of this species.

Patient MB. Chronic calcified maxillary sinusitis, patient had a palate defect. A. fumigatus cultured. Patient MB X rays and CT scans. Chronic calcified maxillary sinusitis, patient had a palate defect.A. fumigatus cultured.Images A&B Plain X rays antero-posterior and lateral, pre-operatively of Pt MB aged 76 who presented with unilateral nasal read more... Image A., Image B., Image C., Image D., Image E., Image F.
Image A., Image B., Image C., Image D., Image E., Image F. Patient MB. Chronic calcified maxillary sinusitis, patient had a palate defect. A. fumigatus cultured. Patient MB X rays and CT scans. Chronic calcified maxillary sinusitis, patient had a palate defect.A. fumigatus cultured.Images A&B Plain X rays antero-posterior and lateral, pre-operatively of Pt MB aged 76 who presented with unilateral nasal read more...
Aspergillus fumigatus
Aspergillus fumigatus

Colonies on CYA 40-60 mm diam, plane or lightly wrinkled, low, dense and velutinous or with a sparse, floccose overgrowth; mycelium inconspicuous, white; conidial heads borne in a continuous, densely packed layer, Greyish Turquoise to Dark Turquoise (24-25E-F5); clear exudate sometimes produced in small amounts; reverse pale or greenish. Colonies on MEA 40-60 mm diam, similar to those on CYA but less dense and with conidia in duller colours (24-25E-F3); reverse uncoloured or greyish. Colonies on G25N less than 10 mm diam, sometimes only germination, of white mycelium. No growth at 5°C. At 37°C, colonies covering the available area, i.e. a whole Petri dish in 2 days from a single point inoculum, of similar appearance to those on CYA at 25°C, but with conidial columns longer and conidia darker, greenish grey to pure grey.

Conidiophores borne from surface hyphae, stipes 200-400 µm long, sometimes sinuous, with colourless, thin, smooth walls, enlarging gradually into pyriform vesicles; vesicles 20-30 µm diam, fertile over half or more of the enlarged area, bearing phialides only, the lateral ones characteristically bent so that the tips are approximately parallel to the stipe axis; phialides crowded, 6-8 µm long; conidia spherical to subspheroidal, 2.5-3.0 µm diam, with finely roughened or spinose walls, forming radiate heads at first, then well defined columns of conidia.

Distinctive features

This distinctive species can be recognised in the unopened Petri dish by its broad, velutinous, bluish colonies bearing characteristic, well defined columns of conidia. Growth at 37°C is exceptionally rapid. Conidial heads are also diagnostic: pyriform vesicles bear crowded phialides which bend to be roughly parallel to the stipe axis. Care should be exercised in handling cultures of this species.

Pt DG pseudomembranous aspergillus tracheobronchitis This patient is a 70 yr old, obese diabetic with aortic stenosis and COPD. He was admitted in early March 09, with collapse and loss of conciousness. His lungs appeared normal at this time - CT and X-ray 1. 10 days later he was admitted with read more... Image A. CT scan 1, one week prior to admission , Image B. CT scan 2, on admission, Image C. CT scan 3: Following 6 weeks antifungal treatment, Image D. CT scan 4 after 3.5 months- and one month on interferon gamma, Image E. Chest X ray 1 (cf CT scan 1) one week pre-admission, Image F. Chest X-ray 2 (cf CT Scan 2) on admission, Image G. Histology (H&E) of membranous material removed on bronchoscopy, Image H. Histology stained with GMS stain showing septate branching hyphae, Image I. Bronchoscopy one week after admission- improvement, with some clear areas with no secretions, less oedema than one week earlier (not shown)., Image J. Bronchoscopy 2 weeks after admission, much improved  only local plaques in distal airways.
Image A. CT scan 1, one week prior to admission , Image B. CT scan 2, on admission, Image C. CT scan 3: Following 6 weeks antifungal treatment, Image D. CT scan 4 after 3.5 months- and one month on interferon gamma, Image E. Chest X ray 1 (cf CT scan 1) one week pre-admission, Image F. Chest X-ray 2 (cf CT Scan 2) on admission, Image G. Histology (H&E) of membranous material removed on bronchoscopy, Image H. Histology stained with GMS stain showing septate branching hyphae, Image I. Bronchoscopy one week after admission- improvement, with some clear areas with no secretions, less oedema than one week earlier (not shown)., Image J. Bronchoscopy 2 weeks after admission, much improved  only local plaques in distal airways. Pt DG pseudomembranous aspergillus tracheobronchitis This patient is a 70 yr old, obese diabetic with aortic stenosis and COPD. He was admitted in early March 09, with collapse and loss of conciousness. His lungs appeared normal at this time - CT and X-ray 1. 10 days later he was admitted with read more...
Chronic Cavitary Pulmonary Aspergillosis and Aspergilloma with Atypical Tuberculosis and Emphysema Image A. June 1999 , Image B. July 2001, Image C. April 2002

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