Date: 26 November 2013
Aspergillus terreus Thom. Conidial head of Aspergillus terreus. Conidial heads are compact, columnar and biseriate. Conidiophores are hyaline to slightly yellow and smooth walled.
Copyright:
With thanks to G Kaminski. D Ellis and R Hermanis Mycology Unit, Women’s & Children’s Hospital , Adelaide, South Australia 5006
Notes:
Colonies on CYA 40-50 mm diam, plane, low and velutinous, usually quite dense; mycelium white; conidial production heavy, brown (Dark Blonde to Camel, 5-6D4); reverse pale to dull brown or yellow brown. Colonies on MEA 40-60 mm diam, similar to those on CYA or less dense. Colonies on G25N 18-22 mm diam, plane or irregularly wrinkled, low and sparse; conidial production light, pale brown; brown soluble pigment sometimes produced; reverse brown. No growth at 5°C. Colonies at 37°C growing very rapidly, 50 mm or more diam, of similar appearance to those on CYA at 25°C.Conidiophores borne from surface hyphae, stipes 100-250 μm long, smooth walled; vesicles 15-20 μm diam, fertile over the upper hemisphere, with densely packed, short, narrow metulae and phialides, both 5-8 μm long; conidia spherical, very small, 1.8-2.5 μm diam, smooth walled, at maturity borne in long, well defined columns.Distinctive featuresVelutinous colonies formed at both 25°C and 37°C, uniformly brown, with no other colouration, and minute conidia borne in long columns make Aspergillus terreus a distinctive species.
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After 3 weeks of posaconazole given for chronic pulmonary aspergillosis, patient NC had a remarkable exacerbation of psoriasis. He had had psoriasis for years, with little trouble and almost no treatment. After taking posaconazole 400mg twice daily, he developed psoriatic plaques on his hands for the first time ever. The plaques on his lower legs became confluent. This occurred in association with worsening chest symptoms, notably increased coughing, more breathlessness and increasing oxygen requirement.
Posaconazole was stopped after 3 weeks, and 2 weeks later he was still very symptomatic with his chest. This responded to a 2 week course of corticosteroids, and his psoriasis also improved.
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Patient PC: An example of localised caspofungin rash and phlebitis related to caspofungin infusion.
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This 55 year old man with asthma, ABPA, severe bronchiectasis and lung fibrosis was treated with voriconazole, starting in June 2010. He had developed increasing dyspnoea on itraconazole for over 7 years, and his total IgE remained at 1100 KIU/L. He had marked photopsia (visual hallucinations) and facial erythema in the first 3 weeks of therapy. His trough voriconazole concentration was 1.17 mg/L. Over 3 months, he had minor improvement in his breathlessness but continued facial erythema, despite factor 50 sunblock. After 5 months of therapy his facial rash has altered to show acneiform lesions with localised crusting and background severe erythema. His face effectively crusted over, and he stopped therapy.
Over the next 3 weeks his facial appearance slowly improved .
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