TY  - JOUR
A1  - Kessel, Johanna
A1  - Hogardt, Michael
A1  - Aspacher, Lukas
A1  - Wichelhaus, Thomas A.
A1  - Gerkrath, Jasmin
A1  - Rosenow, Emely
A1  - Springer, Jan
A1  - Rickerts, Volker
T1  - Exclusion of Mucorales co-infection in a patient with Aspergillus flavus sinusitis by fluorescence in situ hybridization (FISH)
JF  - Journal of Fungi
N2  - Invasive 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.
KW  - invasive fungal infection
KW  - fluorescence in situ hybridization (FISH)
KW  - fungal sinusitis
KW  - mixed infection
KW  - Aspergillus
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-267208
SN  - 2309-608X
VL  - 8
IS  - 3
ER  - 
TY  - JOUR
A1  - Springer, Jan
A1  - Walther, Grit
A1  - Rickerts, Volker
A1  - Hamprecht, Axel
A1  - Willinger, Birgit
A1  - Teschner, Daniel
A1  - Einsele, Hermann
A1  - Kurzai, Oliver
A1  - Loeffler, Juergen
T1  - Detection of Fusarium Species in Clinical Specimens by Probe-Based Real-Time PCR
JF  - Journal of Fungi
N2  - The mold Fusarium is a ubiquitous fungus causing plant, animal and human infections. In humans, Fusarium spp. are the major cause of eye infections in patients wearing contact lenses or after local trauma. Systemic infections by Fusarium spp. mainly occur in immunosuppressed patients and can disseminate throughout the human body. Due to high levels of resistance to antifungals a fast identification of the causative agent is an urgent need. By using a probe-based real-time PCR assay specific for the genus Fusarium we analysed several different clinical specimens detecting Fusarium spp. commonly found in clinical samples in Germany. Also, a large collection of lung fluid samples of haematological patients was analysed (n = 243). In these, two samples (0.8%) were reproducibly positive, but only one could be confirmed by sequencing. For this case of probable invasive fungal disease (IFD) culture was positive for Fusarium species. Here we describe a rapid, probe-based real-time PCR assay to specifically detect DNA from a broad range of Fusarium species and its application to clinically relevant specimens.
KW  - probe-based real-time PCR
KW  - Fusarium
KW  - bronchoalveolar lavage fluid
KW  - fungal molecular diagnostics
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-193111
SN  - 2309-608X
VL  - 5
IS  - 4
ER  -