Uncommon concurrent pulmonary infections: Aspergillus fumigatus and Lomentospora prolificans in an Anti-MDA5 antibody-positive dermatomyositis patient

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, l...

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Main Authors: Maaya Fukumura, Ryosuke Hiwa, Satomi Yukawa, Yasuhiro Tsuchido, Hajime Yoshifuji, Akio Morinobu
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Medical Mycology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2211753924000630
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Summary: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.
ISSN:2211-7539