Post‐influenzal triazole‐resistant aspergillosis following allogeneic stem cell transplantation

• DOI: 10.1111/myc.12770
• Publication Date: 2018-03-23T19:15:04Z
• Authors: Alida Fe Talento; Katie Dunne; Niamh Murphy; Brian O'Connell; Grace Chan; Eimear Ann Joyce; Ferry Hagen; Jacques F. Meis; Ruairi Fahy; Larry Bacon; Elisabeth Vandenb...; Thomas R. Rogers
• Keywords: Male; Antifungal Agents; Drug Resistance; Homologous/adverse effects; Aspergillus fumigatus/drug effects; 03 medical and health sciences; 0302 clinical medicine; Drug Resistance, Fungal; Influenza, Human; Stem Cell Transplantation/adverse effects; Humans; Transplantation, Homologous; Invasive Pulmonary Aspergillosis/diagnosis; Invasive Pulmonary Aspergillosis; Transplantation; Triazoles/pharmacology; Aspergillus fumigatus; Human/complications; Middle Aged; Triazoles; Influenza; 3. Good health; Fungal; Antifungal Agents/pharmacology; Radboudumc 4: lnfectious Diseases and Global Health RIHS: Radboud Institute for Health Sciences; Stem Cell Transplantation

SummaryInfluenza virus infection is now recognised as a risk factor for invasive pulmonary aspergillosis (IPA). Delays in diagnosis contribute to delayed commencement of antifungal therapy. In addition, the emergence of resistance to first‐line triazole antifungal agents puts emphasis on early detection to prevent adverse outcomes. We present 2 allogeneic stem cell transplant patients who developed IPA due to triazole‐resistant Aspergillus fumigatus following influenza infection. We underline the challenges faced in the management of these cases, the importance of early diagnosis and need for surveillance given the emergence of triazole resistance.