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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author Maaya Fukumura
Ryosuke Hiwa
Satomi Yukawa
Yasuhiro Tsuchido
Hajime Yoshifuji
Akio Morinobu
author_facet Maaya Fukumura
Ryosuke Hiwa
Satomi Yukawa
Yasuhiro Tsuchido
Hajime Yoshifuji
Akio Morinobu
author_sort Maaya Fukumura
collection DOAJ
description 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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issn 2211-7539
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publishDate 2025-03-01
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series Medical Mycology Case Reports
spelling doaj-art-a3f7f476963c40a290f5144a4f0a4cea2025-08-20T02:52:21ZengElsevierMedical Mycology Case Reports2211-75392025-03-014710068910.1016/j.mmcr.2024.100689Uncommon concurrent pulmonary infections: Aspergillus fumigatus and Lomentospora prolificans in an Anti-MDA5 antibody-positive dermatomyositis patientMaaya Fukumura0Ryosuke Hiwa1Satomi Yukawa2Yasuhiro Tsuchido3Hajime Yoshifuji4Akio Morinobu5Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, JapanDepartment of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Corresponding author.Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, JapanDepartment of Infection Control and Prevention, Kyoto University Hospital, Kyoto, JapanDepartment of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, JapanDepartment of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, JapanA 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.http://www.sciencedirect.com/science/article/pii/S2211753924000630Anti-MDA5 antibody-positive dermatomyositisRapidly progressive interstitial lung diseaseAspergillus fumigatusLomentospora prolificans
spellingShingle Maaya Fukumura
Ryosuke Hiwa
Satomi Yukawa
Yasuhiro Tsuchido
Hajime Yoshifuji
Akio Morinobu
Uncommon concurrent pulmonary infections: Aspergillus fumigatus and Lomentospora prolificans in an Anti-MDA5 antibody-positive dermatomyositis patient
Medical Mycology Case Reports
Anti-MDA5 antibody-positive dermatomyositis
Rapidly progressive interstitial lung disease
Aspergillus fumigatus
Lomentospora prolificans
title Uncommon concurrent pulmonary infections: Aspergillus fumigatus and Lomentospora prolificans in an Anti-MDA5 antibody-positive dermatomyositis patient
title_full Uncommon concurrent pulmonary infections: Aspergillus fumigatus and Lomentospora prolificans in an Anti-MDA5 antibody-positive dermatomyositis patient
title_fullStr Uncommon concurrent pulmonary infections: Aspergillus fumigatus and Lomentospora prolificans in an Anti-MDA5 antibody-positive dermatomyositis patient
title_full_unstemmed Uncommon concurrent pulmonary infections: Aspergillus fumigatus and Lomentospora prolificans in an Anti-MDA5 antibody-positive dermatomyositis patient
title_short Uncommon concurrent pulmonary infections: Aspergillus fumigatus and Lomentospora prolificans in an Anti-MDA5 antibody-positive dermatomyositis patient
title_sort uncommon concurrent pulmonary infections aspergillus fumigatus and lomentospora prolificans in an anti mda5 antibody positive dermatomyositis patient
topic Anti-MDA5 antibody-positive dermatomyositis
Rapidly progressive interstitial lung disease
Aspergillus fumigatus
Lomentospora prolificans
url http://www.sciencedirect.com/science/article/pii/S2211753924000630
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