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Case Reports
. 2022 Apr 12;4(4):000344.
doi: 10.1099/acmi.0.000344. eCollection 2022.

Cryptic aspergillosis: a rare entity and a diagnostic challenge

Lavanya R  1 , Marilyn M Ninan  1 , Regi Kurien  2 , Fouzia N A  3 , Rani D Sahni  1 , Joy S Michael  1
Affiliations
Case Reports

Cryptic aspergillosis: a rare entity and a diagnostic challenge

Lavanya R et al. Access Microbiol. .

Abstract

Introduction: Cryptic aspergillosis, caused by cryptic species of Aspergillus, is increasingly reported in humans and causes significant morbidity and mortality in immunocompromised individuals. The main aim of this study was to describe the occurrence of this entity at a large tertiary care centre and analyse the challenges in identifying them in a routine diagnostic laboratory.

Methods: This was a retrospective case review of all patients diagnosed with cryptic Aspergillus species from April 2019 to February 2020. The isolates were identified using conventional microbiological techniques, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI- TOF MS), 28S rRNA and internal transcribed spacer (ITS) sequencing.

Results: The species identified were Aspergillus tamarii, Aspergillus lentulus and Aspergillus sydowii. Identification by MALDI- TOF MS and sequencing was concordant for all except A. sydowii, with MALDI- TOF MS misidentifying it as Aspergillus thermomutans. All isolates showed low minimum inhibitory concentrations (MICs) for the panel of antifungal drugs.

Conclusion: Aspergillosis caused by cryptic Aspergillus species presents a diagnostic challenge. This study confirms the importance of molecular methods for accurate identification.

Keywords: AFST (antifungal susceptibility testing); ITS sequencing; MALDI-TOF MS (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry); MEC (minimum effective concentration); cryptic species.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

References

    1. Denning DW UpToDate; 2022. Clinical manifestations and diagnosis of chronic pulmonary aspergillosis.https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-...
    1. Pasqualotto AC, Denning DW. Post-operative aspergillosis. Clin Microbiol Infect. 2006;12:1060–1076. doi: 10.1111/j.1469-0691.2006.01512.x. - DOI - PubMed
    1. Obradovic-Tomasev M, Popovic A, Vuckovic N, Jovanovic M. Mixed fungal infection (Aspergillus, mucor, and Candida) of severe hand injury. Case Rep Infect Dis. 2014;2014:954186. doi: 10.1155/2014/954186. - DOI - PMC - PubMed
    1. Gautier M, Normand A-C, Ranque S. Previously unknown species of Aspergillus . Clin Microbiol Infect. 2016;22:662–669. doi: 10.1016/j.cmi.2016.05.013. - DOI - PubMed
    1. Samson RA, Visagie CM, Houbraken J, Hong S-B, Hubka V, et al. Phylogeny, identification and nomenclature of the genus Aspergillus . Stud Mycol. 2014;78:141–173. doi: 10.1016/j.simyco.2014.07.004. - DOI - PMC - PubMed

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