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Volume 12, Number 3—March 2006
Research

Aspergillus ustus Infections among Transplant Recipients

Anil A. Panackal*†, Alexander Imhof*‡, Edward W. Hanley*, and Kieren A. Marr*†Comments to Author 
Author affiliations: *Fred Hutchinson Cancer Research Center; Seattle, Washington, USA; †University of Washington Medical Center, Seattle, Washington, USA; ‡University Hospital, Zürich, Zürich, Switzerland

Main Article

Table A1

Aspergillus ustus infections reported during the last 10 years*

Pt./ref. Age (y) Sex Underlying condition Diagnosis/site Coinfection Clinical indications Immuno-suppression Management Outcome
(4) 41 M Aortic valve replacement Femoral artery thrombus, endocarditis None Endocarditis with emboli N/A Ampho B and flucytosine, surgery Cure, survived
(5) 57 M Skin burns Skin† Bacterial pneumonia Sharp, demarcated white areas over dorsal hands and arms Prednisone emulsion Ampho B cream Failure, died
(6) 50 M Rheumatic heart disease, prosthetic valve replacement Femoral artery thrombus; endocarditis None Endocarditis with emboli N/A Ampho B and flucytosine, surgery Cure, died
(7) 72 M Cardiovascular disease Lung‡ Bacterial pneumonia Multilobar pneumonia, thyroid, lung, kidney, peritoneum abscesses N/A None Failure, died§
(8) 62 M Cirrhosis, orthotopic liver transplant Skin*‡ None Multiple crusted nodules, plaques Cyclosporin and tacrolimus for rejection Ampho B and terbinafine cream Cure, died
(9) 9 M Allogeneic HSCT Lung None Fever, chest pain, nodular pulmonary opacity N/A Ampho B Failure, died§
(10) 64 F Chronic obstructive pulmonary disease Skin* None Erythematous plaque with pustules, erosions Prednisone Itraconazole Failure, died§
(11) 46 F Allogeneic HSCT Lung, disseminated to skin, heart, thyroid‡ CMV, parainfluenza pneumonia; BK virus hemorrhagic cystitis Bilateral pulmonary consolidation, skin lesion Myeloablative conditioning Itraconazole → liposomal ampho B Failure, died§
(12) 38 M Allogeneic HSCT Lung‡ None Seizures, bronchopneumonia Myeloablative conditioning, GVHD Ampho B spray → ampho B Failure, died
(13) 77 F Frontotemporal astrocytoma Skin* None Ulcerative erythematous plaque, suppuration Dexamethasone Itraconazole + KMnO4 soaks Failure, died
(14) 19 F Allogeneic HSCT Skin* Bacteremia Skin ulcers Myeloablative conditioning, GVHD Ampho B Failure, died§
(15) 43 M Leukemia Lung None Neutropenic fever, pulmonary infiltrates cytarabine and idarubicin Ampho B → voriconazole surgery Cure, died
(16) N/A N/A Allogeneic HSCT Lung, skin N/A N/A Chronic GVHD Liposomal ampho B N/A
(17) 29 M Allogeneic HSCT Lung, skin, brain dissemination None Pulmonary infiltrates and skin lesions Myeloablative conditioning, GVHD Ampho B → liposomal ampho B and caspofungin Cure, died
(17) 17 M Allogeneic HSCT Lung disseminated to eye, brain, skin None Retinitis and skin lesions GVHD Voriconazole and ampho B Failure, died
This article (case 1) 42 M Allogeneic HSCT Proven lung Bacterial pneumonia Pleural-based nodules GVHD Liposomal ampho B and caspofungin Failure, Died §
This article (case 2) 29 M Allogeneic HSCT Probable lung A. fumigatus pneumonia Cough, dyspnea, and pulmonary nodules GVHD Liposomal ampho B and caspofungin Failure, died
This article (case 3) 62 M Leukemia Probable lung None Pulmonary consolidation Fludarabine, Rituximab, Corticosteroids Liposomal ampho B → voriconazole and caspofungin Cure, survived
This article (case 4) 59 M Allogeneic HSCT Probable lung Influenza B Fever, chills, and dyspnea, pulmonary consolidation GVHD Voriconazole and caspofungin Cure, survived
This article (case 5) 48 F Allogeneic HSCT Proven lung, skin dissemination CMV pneumonitis Pulmonary infiltrates and erythematous papular skin lesions GVHD Voriconazole and caspofungin → liposomal ampho B Failure, died§
This article (case 6) 69 M Allogeneic HSCT Probable lung CMV antigenemia Dyspnea and pulmonary opacity GHVD Voriconazole and Caspofungin Cure, survived

*GVHD, graft-versus-host disease; N/A, data not applicable or not reported; HSCT, hematopoietic stem cell transplant; CMV, cytomegalovirus; Ampho B, amphotericin V; KMnO4, potassium permanganate.
†Primary cutaneous infection.
‡Nosocomial acquired infection.
§Mortality attributed to A. ustus infection.

Main Article

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