Cutaneous Infection Caused by Aspergillus ustus , an Emerging Opportunistic Fungus in Immunosuppressed Patients

Abstract

We report a case of primary cutaneous infection by the emerging fungus Aspergillus ustus in an immunosuppressed patient after a domestic accident. The patient failed to respond to itraconazole and died before receiving a new treatment with amphotericin B. There have been eight other cases reported since 1973, and only two patients survived the infection. In vitro susceptibility testing of seven antifungal drugs showed that terbinafine and the new azole derivative UR-9825 were the most active against this fungus.

Use of Lung Resection and Voriconazole for Successful Treatment of Invasive Pulmonary Aspergillus ustus Infection

“…A. fumigatus, A. flavus, and A. terreus are the most common species. To date only 10 cases of infections caused by A. ustus have been reported (5,14,23). Four of the 10 patients suffered from IPA (2,11,23,25), and all of the patients died of fungal disease.…”

Primary Gangrenous Cutaneous Mold Infections in a Patient with Cancer and Neutropenia

“…32 Penetrating trauma remains the major cause of primary cutaneous zygomycosis (Table 2). [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Other causes reported include elasticized bandages and wound dressings, 55 burns, 56 motor vehicle collision, 57 intravenous access, 58 and dog bite. 59 Our case report of primary cutaneous mucormycosis after a cat bite is a rare finding.…”

“…66 The higher overall mortality rate of 29.4% seen in the review of the literature was observed more frequently in patients with neutropenia (60.0%) and without surgical intervention (73.3%), and the survival rate was higher (35.3%) for cases utilizing both antifungal and surgical interventions. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] The antifungal agent with the highest survival rate was amphotericin B and its formulations (58.8%). [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] …”

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] In patients with hematological malignancy and primary cutaneous mold infection, outcomes were determined on whether or not the infection was localized vs disseminated. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] In cases in which the infection remained localized, 100% of patients recov- ered; by contrast, in cases of disseminated infection, the mortality rate was 29.4%. [5][6][7][8][9][10][11][12][13][14][15][16][17]…”

Climate change and primary industries

“…There is increasingly greater focus on moulds as agents of infection in immunocompromised individuals, such as AIDS, cancer or transplant recipient patients undergoing hospital treatment (Gené et al 2001, White 2005, Kauffman 2006, Nucci and Anaissie 2006. The costs of using antifungal medicine have skyrocketed in many hospitals in recent years.…”