Scopulariopsis/Microascus Isolation in Lung Transplant Recipients: A Report of Three Cases and a Review of the Literature
Linna Huang Wenhui Chen Lijuan Guo Li Zhao Bin Cao Yingmei Liu Binghuai Lu Binbin Li Jingyu Chen Chen Wang
First published: 05 June 2019 https://doi.org/10.1111/myc.12952
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/myc.12952
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Abstract
Background
The current knowledge of invasive Scopulariopsis/Microascus infection in lung transplantationhasbeen derived from only four case reports. Although these fungi are uncommon compared with Aspergillus, they are highly resistant to the current antifungal agents, and the mortality is extremely high.
Objectives
To explore the risk factors, clinical manifestations, notable diagnostic characteristics and outcomes of positive Scopulariopsis/Microascusisolation in lung transplantation patients.
Methods
We included all cases with positive Scopulariopsis/Microascus isolation from lower respiratory tractsor bronchial mucosa biopsiesin our lung transplantation centre. Proven cases from the literature were added.
Results
Positive isolation occurred in 2% (3/157) in our centre. Four cases from the literature were added.The mortality could be considered as high as 80%, once the two cases of colonization were excluded. The average interval between transplantation and positiveisolation was 106 (19‐131) days. A total of 57.1% of patients had experienced a combination of infection with Aspergillus or other fungi as well as long‐term azole antifungal agent treatment before the positive isolation, which may be possible risk factors. The combination of micafungin, posaconazole and terbinafine may be an effective treatment.
Conclusions
The peak time of positive isolation was consistent with that of some opportunistic pathogens, and the possible risk factors were the infection of other fungi as well as prior long‐term azole antifungal administration. In addition toits high mortality, Scopulariopsis/Microascus was also highly resistant to common antifungal agents and the combination of two or three drugs for therapy was recommended.
Linna Huang Wenhui Chen Lijuan Guo Li Zhao Bin Cao Yingmei Liu Binghuai Lu Binbin Li Jingyu Chen Chen Wang
First published: 05 June 2019 https://doi.org/10.1111/myc.12952
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/myc.12952
ePDFPDFTOOLS SHARE
Abstract
Background
The current knowledge of invasive Scopulariopsis/Microascus infection in lung transplantationhasbeen derived from only four case reports. Although these fungi are uncommon compared with Aspergillus, they are highly resistant to the current antifungal agents, and the mortality is extremely high.
Objectives
To explore the risk factors, clinical manifestations, notable diagnostic characteristics and outcomes of positive Scopulariopsis/Microascusisolation in lung transplantation patients.
Methods
We included all cases with positive Scopulariopsis/Microascus isolation from lower respiratory tractsor bronchial mucosa biopsiesin our lung transplantation centre. Proven cases from the literature were added.
Results
Positive isolation occurred in 2% (3/157) in our centre. Four cases from the literature were added.The mortality could be considered as high as 80%, once the two cases of colonization were excluded. The average interval between transplantation and positiveisolation was 106 (19‐131) days. A total of 57.1% of patients had experienced a combination of infection with Aspergillus or other fungi as well as long‐term azole antifungal agent treatment before the positive isolation, which may be possible risk factors. The combination of micafungin, posaconazole and terbinafine may be an effective treatment.
Conclusions
The peak time of positive isolation was consistent with that of some opportunistic pathogens, and the possible risk factors were the infection of other fungi as well as prior long‐term azole antifungal administration. In addition toits high mortality, Scopulariopsis/Microascus was also highly resistant to common antifungal agents and the combination of two or three drugs for therapy was recommended.
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