Volume 25, Number 12—December 2019
Research Letter
Aspergillus felis in Patient with Chronic Granulomatous Disease
Olivier Paccoud, Romain Guery, Sylvain Poirée, Grégory Jouvion, Marie Elisabeth Bougnoux, Emilie Catherinot, Olivier Hermine, Olivier Lortholary, and Fanny Lanternier
Table
Defining features of invasive pulmonary aspergillosis and allergic bronchopulmonary aspergillosis in a 42-year-old man with X-linked chronic granulomatous disease, Paris, France*
| Category | Defining features |
|||
|---|---|---|---|---|
| IPA (oncohematologic setting) | IPA during CGD | Patient in this study | ABPA | |
| Underlying disease | Neutropenia | CGD, particularly X-linked CGD | X-linked CGD | Asthma, cystic fibrosis |
| Mechanisms of disease | Angioinvasion | Tissue invasion, little or no angioinvasion | No angioinvasion | Exaggerated inflammatory response to Aspergillus |
| Course of infection | Acute, single event | Subacute or chronic, single event | Subacute, single event | Chronic with exacerbations |
| Radiographic findings | Cavitation, pulmonary infarction, air crescent sign, halo sign | Single or multiple nodules and consolidations | Single consolidation | Central bronchiectasis, pulmonary infiltrates, mucus plugs |
| Galactomannan testing | Positive | Positive or negative | Negative | Negative |
| Total serum IgE | Normal | Normal | Elevated (1,410 IU/L) | Elevated (>1,000 IU/L) |
| Aspergillus species-specific IgE or skin test reactivity | Negative | Negative | Positive (7 IU/mL) | Positive (>0.1 IU/mL) |
| Aspergillus IgG | Negative | Negative | Positive (54 IU/mL) | Positive (>10 IU/mL) |
| Precipitating antibodies to Aspergillus | Negative | Negative | Positive (2 arcs of precipitation) | Positive (>1 arc of precipitation) |
| Blood eosinophilia | Absent | Absent; reported only during “fulminant mulch pneumonia” | Present (2.2 × 109 cells/L) | Present (>0.5 × 109 cells/L) |
| First-line treatment | Antifungal treatment | Antifungal treatment | Antifungal treatment | Systemic or inhaled corticosteroids |
*ABPA, allergic bronchopulmonary aspergillosis; CGD, chronic granulomatous disease; IPA, invasive pulmonary aspergillosis.
Page created: November 18, 2019
Page updated: November 18, 2019
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