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Journal of Clinical Microbiology, October 2009, p. 3372-3375, Vol. 47, No. 10
0095-1137/09/$08.00+0     doi:10.1128/JCM.00671-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

CASE REPORT

Atypical Aspergillus flavus Isolates Associated with Chronic Azole Therapy{triangledown}

Mary E. Brandt,1* Lalitha Gade,1 Cindy B. McCloskey,2 and S. Arunmozhi Balajee1

Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333,1 Emory University Hospital, Atlanta, Georgia 303292

Received 2 April 2009/ Returned for modification 17 April 2009/ Accepted 29 July 2009

A case of chronic sinus disease due to morphologically atypical Aspergillus flavus is described. Multiple fungal isolates sporulated poorly or not at all, displaying unusual color and microscopic morphology, including the absence of typical vesicles and phialides, which caused the isolates to resemble several other fungal genera superficially. The patient received multiple antifungal therapies over at least 10 years with various azole drugs, including voriconazole, itraconazole, and posaconazole. We speculate that this lengthy exposure to azole antifungal drugs may have caused or promoted the atypical morphology seen in these isolates.

* Corresponding author. Mailing address: Mycotic Diseases Branch, Centers for Disease Control and Prevention, 600 Clifton Road, Mailstop G-11, Atlanta, GA 30333. Phone: (404) 639-0281. Fax: (404) 639-3021. E-mail: mbb4{at}cdc.gov

{triangledown} Published ahead of print on 5 August 2009.

Journal of Clinical Microbiology, October 2009, p. 3372-3375, Vol. 47, No. 10
0095-1137/09/$08.00+0     doi:10.1128/JCM.00671-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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