Subject(s)
Precursor Cell Lymphoblastic Leukemia-Lymphoma , Pyridazines , Aged , Frail Elderly , Humans , Imidazoles , Philadelphia Chromosome , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Protein Kinase Inhibitors/therapeutic use , Pyridazines/therapeutic use , Steroids/therapeutic useSubject(s)
Antibodies, Monoclonal/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cytomegalovirus , Multiple Myeloma/drug therapy , Virus Activation , Aged , Antineoplastic Agents, Immunological/therapeutic use , Cytomegalovirus/drug effects , Cytomegalovirus/physiology , Cytomegalovirus Infections/virology , Female , Humans , Male , Middle Aged , Multiple Myeloma/virology , Virus Activation/drug effectsABSTRACT
An 80 year old male who had received immunosuppressive therapy for myelodysplastic syndrome presented with fever, fatigue, and elevated serum Aspergillus antigen. Computed tomography revealed infiltrative shadows in the left lower lung and subcutaneous nodules. A polymerase chain reaction assay from lung and subcutaneous nodule samples identified the presence Aspergillus udagawae. A. udagawae is a cryptic species that shares similar morphological characteristics with A. fumigatus but genetically differs from the latter in its susceptibility to antifungal drugs. When immunosuppressed patients with hematological malignancies develop disseminated aspergillosis, biopsy and fungal tests are crucial to identify the causative fungus, including cryptic species, for deciding the appropriate therapeutic intervention.