Volume 31, Number 5—May 2025
CME ACTIVITY - Synopsis
Features of Invasive Aspergillosis Caused by Aspergillus flavus, France, 2012–2018
Lise Bertin-Biasutto, Olivier Paccoud, Dea Garcia-Hermoso, Blandine Denis, Karine Boukris-Sitbon, Olivier Lortholary, Stéphane Bretagne, Maud Gits-Muselli, Raoul Herbrecht, Valérie Letscher-Bru, François Danion, Sophie Cassaing, Florent Morio, Céline Nourrisson, Marc Pihet, Milène Sasso, Guillaume Desoubeaux, Marie-Fleur Durieux, Julie Bonhomme, Elisabeth Chachaty, Taieb Chouaki, Nicole Desbois-Nogard, Alexandre Alanio1, Jean-Pierre Gangneux1, and Fanny Lanternier
Table 1
Characteristics of 54 patients with probable or proven invasive aspergillosis caused by Aspergillus flavus, France, 2012–2018*
| Characteristics | Value |
|---|---|
| Median age, y (IQR) |
58 (48–70) |
| Originating from Africa, n = 50 |
14 (28) |
| Diagnosis during April 1–Oct 31 |
32 (59.2) |
| Sex | |
| M | 26 (48.1) |
| F |
28 (51.8) |
| Primary underlying risk factor | |
| Malignancy | 31 (57.4) |
| Solid organ cancer | 2 (3.7) |
| Hematologic malignancy, n = 29 | 29 (54) |
| Acute myeloid leukemia | 10 (34.5) |
| Acute lymphoid leukemia | 10 (34.5) |
| Lymphoma | 2 (6.9) |
| Chronic lymphoid leukemia | 2 (6.9) |
| Other hematologic malignancy | 5 (17.2) |
| Solid organ transplant, n = 9 | 9 (16.7) |
| Kidney | 3 (33.3) |
| Heart | 3 (33.3) |
| Lung | 2 (22.2) |
| Liver | 1 (11.1) |
| Diabetes mellitus | 8 (14.8) |
| Severe burns | 2 (3.7) |
| Other immunodeficiency, n = 2 | 2 (3.7) |
| HIV | 1 (50) |
| Iatrogenic agranulocytosis | 1 (50) |
| No risk factor |
2 (3.7) |
| Median time between onset of symptoms and diagnosis, d (IQR) |
20 (10–50) |
| Site of infection | |
| Localized infections, n = 47 | 47 (87) |
| Pulmonary† | 33 (70.2) |
| Ear-nose-throat† | 13 (27.7) |
| Cerebral contiguous extension‡ | 10 (21.3) |
| Skin and soft tissue | 1 (2.1) |
| Disseminated infections, n = 7 | 7 (13) |
| Pulmonary | 6 (85.7) |
| Ear-nose-throat | 2 (28.8) |
| Cerebral | 2 (28.8) |
| Skin and soft tissue | 5 (71.4) |
| Fungemia |
2 (28.6) |
| Positive serum galactomannan antigen, n = 38 |
23 (60.5) |
| Proven infection |
24 (44.4) |
| Fungal coinfection at same site as A. flavus, n = 16§ | 16 (29.7) |
| A. fumigatus | 6 (37.5) |
| A. niger | 3 (18.8) |
| Mucorales | 5 (31.2) |
| Pneumocystis jirovecii | 3 (18.8) |
| Candidemia |
1 (6.2) |
| Influenza coinfection |
2 (3.7) |
| First-line antifungal therapy, including combinations, n = 50 | |
| Voriconazole | 32 (64) |
| Posaconazole | 3 (6) |
| Itraconazole | 2 (4) |
| Isavuconazole | 2 (4) |
| Liposomal amphotericin B | 9 (18) |
| Echinocandin | 7 (14) |
| Antifungal combination |
5 (10) |
| Death, n = 51 patients with outcome data | |
| 30-day case-fatality, all causes | 20 (39.2) |
| 90-day case-fatality, all causes | 24 (47.1) |
*Values are no. (%) patients except as indicated. †Four patients had lung and ear-nose-throat infections. ‡All were sinus infections with contiguous cerebral lesions. §Including 1 case with 3 fungal co-infections.
1These authors contributed equally contributed to this article.
Page created: March 19, 2025
Page updated: April 29, 2025
Page reviewed: April 29, 2025
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