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Mistaken Identity: Neosartorya pseudofischeri and Its Anamorph Masquerading as Aspergillus fumigatus

Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, Seattle, Washington,¹ Centers for Disease Control and Prevention, Atlanta, Georgia,² City of Hope Medical Center, Duarte, California,³ Fungus Testing Laboratory, University of Texas Health Science Center at San Antonio, San Antonio, Texas,⁴ Departments of Medicine and Microbiology, University of Washington, Seattle, Washington⁵

Received 16 June 2005/ Returned for modification 12 July 2005/ Accepted 22 September 2005

Invasive fungal infections caused by Neosartorya pseudofischeri S. W. Peterson [anamorph Aspergillus thermomutatus (Paden) S. W. Peterson] are extremely rare. Phenotypically, the anamorphic state of N. pseudofischeri resembles Aspergillus fumigatus, the predominant agent of invasive aspergillosis in immunocompromised hosts. We report the recovery of three clinical isolates of N. pseudofischeri, all initially misidentified by morphological characteristics as A. fumigatus. All three isolates were correctly identified by sequencing portions of the ß-tubulin and the rodlet A genes. Only one of the three isolates produced the confirmatory fruiting bodies and was thus classified as N. pseudofischeri; the other isolates did not produce asci and were therefore identified as A. thermomutatus. All three isolates had higher MICs to voriconazole in vitro compared to A. fumigatus Af293. This report emphasizes that phenotypic identification of filamentous fungi may not identify morphologically similar, but genetically distinct, members of the genus Aspergillus section Fumigati. Accurate identification of these organisms may be clinically meaningful, given their potential differences in antifungal susceptibilities.

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