Pulmonary aspergillosis caused by a pan-azole-resistant Aspergillus fumigatus in a 10-year-old boy

Abstract

A 10-year-old boy with high-risk acute lymphoblastic leukemia treated with hematopoietic stem-cell transplantation developed pulmonary aspergillosis while receiving prophylactic voriconazole. A transpleural aspirate culture revealed a pan-azole-resistant Aspergillus fumigatus. Treatment with liposomal amphotericin B resulted in complete recovery. As the frequency of azole resistance in A. fumigatus increases, invasive procedures to isolate fungi for species identification and susceptibility testing becomes even more important.