A Case Report on Aspergillus lentulus Pneumonia.

Background: Aspergillus lentulus was described as a new species in 2005 but it was isolated from Turkey for the first time. Case report: A. lentulus was isolated as the cause of pneumonia from a patient who had renal transplantation 4 months ago. The patient received immunosuppressive treatment after transplantation. A. lentulus was isolated from his sputum as an agent in pneumonia developed 4 months after the transplantation. Leukocytes, blastospores, and hyphae were seen in both Gram- and Giemsa-stained smears of the sputum. The isolate was identified by using the Maren A. Klich algorithm and molecular methods and confirmed by the reference laboratory of the CBS Fungal Biodiversity Centre (The Netherlands). In the susceptibility tests of the isolate, minimal inhibitory concentrations for amphotericin B, voriconazole, posaconazole, and caspofungin were found to be 0.5 amicro;g/mL, 0.25 amicro;g/mL, 0.125 amicro;g/mL, and 0.25 amicro;g/mL, respectively. The patient recovered with voriconazole treatment (2x200 mg/day). Conclusion: The use of the molecular tests is important for identification of A. lentulus strains because they are very easily confused with A.fumigatus strains according to phenotypic characteristics. Turkish Baslik:Aspergillus Lentulus Pnomonisi Olgu Sunumu Anahtar Kelimeler:Invaziv pulmoner aspergillosis, immunkompromize konak, Aspergillus lentulus Arkaplan: Aspergillus lentulus 2005 yilinda yeni bir tur olarak tanimlandi ancak Turkiye'den ilk kez izole edildi. Olgu Sunumu: Dort ay once renal transplantasyon olan bir hastadan pnomoni etkeni olarak A.lentulus izole edildi. Transplantasyon sonrasi hasta immunsupresif tedavi aldi. Transplantasyondan dort ay sonra gelisen pnomonide hastanin balgamindan etken olarak A.lentulus izole edildi. Balgamin Gram ve Giemsa boyali yaymalarinin her ikisinde lokositler, blastosporlar ve hifler goruldu. Izolat Maren A. Klich algoritmasi ve molekuler yontemler kullanilarak isimlendirildi ve CBS Fungal Biodiversity Centre (Hollanda) Referans Laboratuvari'nda dogrulandi. Izolatin duyarlilik testlerinde amfoterisin B, vorikonazol, posakonazol ve kaspofungin icin minimal inhibitor konsantrasyonlar sirasiyla 0.5 amicro;g/mL, 0.25 amicro;g/mL, 0.125 amicro;g/mL ve 0.25 amicro;g/mL olarak saptandi. Hasta vorikonazol (2x200 mg/gun) tedavisiyle iyilesti. Sonuc: A.lentulus kokenleri fenotipik ozelliklerine gore A.fumigatus kokenleriyle cok kolay karisabildiginden isimlendirmede molekuler testlerin kullanimi onemlidir.