Uncommon concurrent pulmonary infections: Aspergillus fumigatus and Lomentospora prolificans in an Anti-MDA5 antibody-positive dermatomyositis patient.
{"title":"Uncommon concurrent pulmonary infections: <i>Aspergillus fumigatus</i> and <i>Lomentospora prolificans</i> in an Anti-MDA5 antibody-positive dermatomyositis patient.","authors":"Maaya Fukumura, Ryosuke Hiwa, Satomi Yukawa, Yasuhiro Tsuchido, Hajime Yoshifuji, Akio Morinobu","doi":"10.1016/j.mmcr.2024.100689","DOIUrl":null,"url":null,"abstract":"<p><p>A 59-year-old female with anti-MDA5 antibody-positive dermatomyositis was treated with prednisolone, tacrolimus, cyclophosphamide, tofacitinib, and plasma exchange. Five months post-treatment, elevated β-D-glucan levels and a pulmonary shadow on CT were noted. <i>Aspergillus fumigatus</i> was identified, leading to voriconazole initiation. A new pulmonary cavity lesion later revealed <i>Lomentospora prolificans</i>. Considering voriconazole resistance, terbinafine was added, resulting in clinical improvement. Vigilant infection monitoring is crucial during anti-MDA5 antibody-positive dermatomyositis treatment.</p>","PeriodicalId":51724,"journal":{"name":"Medical Mycology Case Reports","volume":"47 ","pages":"100689"},"PeriodicalIF":1.6000,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699597/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Mycology Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.mmcr.2024.100689","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
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Abstract
A 59-year-old female with anti-MDA5 antibody-positive dermatomyositis was treated with prednisolone, tacrolimus, cyclophosphamide, tofacitinib, and plasma exchange. Five months post-treatment, elevated β-D-glucan levels and a pulmonary shadow on CT were noted. Aspergillus fumigatus was identified, leading to voriconazole initiation. A new pulmonary cavity lesion later revealed Lomentospora prolificans. Considering voriconazole resistance, terbinafine was added, resulting in clinical improvement. Vigilant infection monitoring is crucial during anti-MDA5 antibody-positive dermatomyositis treatment.
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