Case Commentary: Long-Term Fosmanogepix Use in a Transplant Recipient with Disseminated Aspergillosis Caused by Azole-Resistant Aspergillus calidoustus

Antimicrob Agents Chemother. 2022 Mar 15;66(3):e0236821. doi: 10.1128/aac.02368-21. Epub 2022 Jan 24.

Abstract

Aspergillus calidoustus is an emerging, azole-resistant, cryptic Aspergillus species in immunosuppressed patients that often features extrapulmonary involvement and carries high mortality. The case presented by J. F. Camargo, R. Jabr, A. D. Anderson, L. Lekakis, et al. (Antimicrob Agents Chemother 66:e02206-21, 2022, https://doi.org/10.1128/aac.02206-21) describes a transplant recipient with disseminated A. calidoustus infection who was successfully treated with surgical source control, tapering of immunosuppression, and long-term, combination antifungal treatment that included the first-in-class fosmanogepix, which targets fungal mannoprotein trafficking and anchoring.

Keywords: Aspergillus calidoustus; azole resistance; cryptic Aspergillus species; disseminated aspergillosis; fosmanogepix.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Aspergillosis* / microbiology
  • Aspergillus
  • Aspergillus fumigatus
  • Azoles* / pharmacology
  • Azoles* / therapeutic use
  • Drug Resistance, Fungal
  • Humans
  • Microbial Sensitivity Tests
  • Transplant Recipients

Substances

  • Antifungal Agents
  • Azoles

Supplementary concepts

  • Aspergillus calidoustus