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2022-03-16Zeitschriftenartikel
Exclusion of Mucorales Co-Infection in a Patient with Aspergillus flavus Sinusitis by Fluorescence In Situ Hybridization (FISH)
dc.contributor.authorKessel, Johanna
dc.contributor.authorHogardt, Michael
dc.contributor.authorAspacher, Lukas
dc.contributor.authorWichelhaus, Thomas A.
dc.contributor.authorGerkrath, Jasmin
dc.contributor.authorRosenow, Emely
dc.contributor.authorSpringer, Jan
dc.contributor.authorRickerts, Volker
dc.date.accessioned2022-06-14T12:08:46Z
dc.date.available2022-06-14T12:08:46Z
dc.date.issued2022-03-16none
dc.identifier.other10.3390/jof8030306
dc.identifier.urihttp://edoc.rki.de/176904/9814
dc.description.abstractInvasive fungal infections are associated with increased mortality in hematological patients. Despite considerable advances in antifungal therapy, the evaluation of suspected treatment failure is a common clinical challenge requiring extensive diagnostic testing to rule out potential causes, such as mixed infections. We present a 64-year-old patient with secondary AML, diabetes mellitus, febrile neutropenia, and sinusitis. While cultures from nasal tissue grew Aspergillus flavus, a microscopic examination of the tissue was suggestive of concomitant mucormycosis. However, fluorescence in situ hybridization (FISH) using specific probes targeting Aspergillus and Mucorales species ruled out mixed infection. This was confirmed by specific qPCR assays amplifying the DNA of Aspergillus, but not of Mucorales. These results provided a rational basis for step-down targeted therapy, i.e., the patient received posaconazole after seven days of calculated dual therapy with liposomal amphotericin B and posaconazole. Despite clinical response to the antifungal therapy, he died due to the progression of the underlying disease within two weeks after diagnosis of fungal infection. Molecular diagnostics applied to tissue blocks may reveal useful information on the etiology of invasive fungal infections, including challenging situations, such as with mixed infections. A thorough understanding of fungal etiology facilitates targeted therapy that may improve therapeutic success while limiting side effects.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectinvasive fungal infectioneng
dc.subjectfluorescence in situ hybridization (FISH)eng
dc.subjectfungal sinusitiseng
dc.subjectAspergilluseng
dc.subjectmixed infectioneng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleExclusion of Mucorales Co-Infection in a Patient with Aspergillus flavus Sinusitis by Fluorescence In Situ Hybridization (FISH)none
dc.typearticle
dc.identifier.urnurn:nbn:de:0257-176904/9814-3
dc.type.versionpublishedVersionnone
local.edoc.container-titleJournal of Funginone
local.edoc.container-issn2309-608Xnone
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://www.mdpi.com/2309-608X/8/3/306/htmnone
local.edoc.container-publisher-nameMDPInone
local.edoc.container-volume8none
local.edoc.container-issue3none
local.edoc.container-year2022none
dc.description.versionPeer Reviewednone

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