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Lung Abscess Due to Aspergillus lentulus and Pseudomonas aeruginosa in a Patient With Granulomatosis With Polyangiitis: Case and Review of the Literature

Ilieva, Valeria, MD*†; Thomas, Elaine, MD; Walraven, Carla, MS, PharmD; Sutton, Deanna, A., PhD§; Wiederhold, Nathan, PharmD§; Lee, Samuel, A., MD, PhD*†

Infectious Diseases in Clinical Practice: March 2018 - Volume 26 - Issue 2 - p 100–105
doi: 10.1097/IPC.0000000000000536
Case Reports

Aspergillus lentulus has been recognized within Aspergillus section Fumigati as a phenotypically similar but genetically distinct species, displaying reduced susceptibility to antifungal agents. It has been described as a cause of invasive aspergillosis in patients who underwent hematopoietic stem cell transplantation, solid organ transplant recipients, those on prolonged corticosteroid therapy, or in patients with structural lung disease including chronic obstructive pulmonary disease. We report a case of successful treatment of probable invasive pulmonary aspergillosis due to A. lentulus and polymicrobial infection with Pseudomonas aeruginosa in a patient with relapsing granulomatosis with polyangiitis and recent high-dose steroid therapy.

The authors report a case of successful treatment of probable pulmonary aspergilosis due to Aspergillus lentulus and polymicrobial infection with Pseudomonas aeruginosa in a patient with connective tissue disease, who had been treated with high-dose steroids. A. lentulus has recently been described within the species of A. fumigatus complex, has variable resistance to antifungal agents, and is known to cause an invasive infection in immunocompromised hosts. The authors review the literature and discuss risk factors and management considerations.

From the *Section of Infectious Diseases, New Mexico Veterans Administration (VA) Healthcare System; and †Division of Infectious Diseases and ‡College of Pharmacy, University of New Mexico Health Science Center, Albuquerque, NM; and §Fungus Testing Laboratory, Department of Pathology & Laboratory Medicine, South Texas Reference Laboratories, University of Texas Health Science Center at San Antonio, San Antonio, TX.

Correspondence to: Valeria Ilieva, MD; Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico, 1 University Blvd, Albuquerque, NM 87131. E-mail: vilieva@salud.unm.edu.

The authors have no funding or conflicts of interest to disclose.

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