Aspergillus lentulus: An Under-recognized Cause of Antifungal Drug-Resistant Aspergillosis

Saman Nematollahi; Nitipong Permpalung; Sean X Zhang; Megan Morales; Kieren A Marr

doi:10.1093/ofid/ofab392

Aspergillus lentulus: An Under-recognized Cause of Antifungal Drug-Resistant Aspergillosis

Open Forum Infect Dis. 2021 Aug 29;8(8):ofab392. doi: 10.1093/ofid/ofab392. eCollection 2021 Aug.

Authors

Saman Nematollahi¹, Nitipong Permpalung^{1

2}, Sean X Zhang³, Megan Morales⁴, Kieren A Marr¹

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
² Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
³ Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
⁴ Division of Infectious Diseases, Department of Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA.

Abstract

Aspergillus lentulus is a drug-resistant species that is phenotypically similar to A. fumigatus. It was discovered as a cause of azole-breakthrough disease, consistent with in vitro resistance. Clinical labs can misidentify the species as fumigatus based on phenotypic typing. We describe 4 recent cases and provide a brief review.

Keywords: Aspergillus lentulus; DNA sequencing; MALDI-TOF MS; cryptic species; multidrug resistance; pulmonary aspergillosis.