1. Fatal disseminated Rasamsonia infection in cystic fibrosis post-lung transplantation
- Author
-
Gina Hong, Deanna A. Sutton, Christian Massire, Marissa J. White, Xinglun Liang, Brian L. Wickes, Jianmin Fu, Noah Lechtzin, Robert Lovari, Nathan P. Wiederhold, Richard S. Lee, Natalie E. West, Lawrence B. Blyn, Sean X. Zhang, Robin K. Avery, and Heather Miller
- Subjects
Adult ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,food.ingredient ,Cystic Fibrosis ,medicine.medical_treatment ,030106 microbiology ,Population ,Opportunistic Infections ,Cystic fibrosis ,Immunocompromised Host ,03 medical and health sciences ,Fatal Outcome ,Postoperative Complications ,0302 clinical medicine ,food ,medicine ,Humans ,Lung transplantation ,030212 general & internal medicine ,education ,Immunosuppression Therapy ,education.field_of_study ,Lung ,Lung Diseases, Fungal ,business.industry ,Immunosuppression ,medicine.disease ,Transplantation ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Immunology ,Female ,business ,Invasive Fungal Infections ,Lung Transplantation ,Respiratory tract ,Rasamsonia - Abstract
Background Disseminated fungal infections are a known serious complication in individuals with cystic fibrosis (CF) following orthotopic lung transplantation. Aspergillus fumigatus and Scedosporium species are among the more common causes of invasive fungal infection in this population. However, it is also important for clinicians to be aware of other emerging fungal species which may require markedly different antifungal therapies. Case summary We describe the first laboratory-documented case of a fatal disseminated fungal infection caused by Rasamsonia aegroticola in a 21-year-old female CF patient status post-bilateral lung transplantation, which was only identified post-mortem. Molecular analysis revealed the presence of the identical Rasamsonia strains in the patient's respiratory cultures preceding transplantation. Discussion We propose that the patient's disseminated fungal disease and death occurred as a result of recrudescence of Rasamsonia infection from her native respiratory system in the setting of profound immunosuppression post-operatively. Since Rasamsonia species have been increasingly recovered from the respiratory tract of CF patients, we further review the literature on these fungi and discuss their association with invasive fungal infections in the CF lung transplant host. Conclusion Our report suggests Rasamsonia species may be important fungal pathogens that may have fatal consequences in immunosuppressed CF patients after solid organ transplantation.
- Published
- 2017