Table 1.
Case presentation
|
Case |
Sample type |
Diagnosis |
MALDI-TOF MS |
Sequencing |
Immune status |
Antifungal susceptibility testing |
Neutrophil counts |
Medical management |
Surgical management |
Outcome |
|---|---|---|---|---|---|---|---|---|---|---|
|
1. |
Tissue (right spheno-ethmoidal recess) |
Chronic invasive fungal sinusitis |
A. tamarii |
A. tamarii |
Immunocompetent |
Pan-susceptible |
76% |
I/V amphotericin B |
Endoscopic debridement and palatectomy |
Well at discharge |
|
2. |
Tissue (right maxillary sinus) |
Allergic fungal rhino sinusitis |
A. tamarii |
A. tamarii |
Immunocompetent |
Pan-susceptible |
Not available |
No antifungals; oral amoxicillin and prednisolone |
Submucosal resection with septoplasty, FESS |
Well at discharge |
|
3. |
Tissue (left lung aspergilloma) |
Left lung aspergilloma hyper IgE syndrome |
A. lentulus |
A. lentulus |
Immunocompromised |
Pan-susceptible |
66% |
I/V amphotericin B, oral voriconazole |
Thoracotomy with decortication of aspergilloma |
Died |
|
4. |
Tissue (brain biopsy) |
Multiple fungal brain abscess, beta thalassemia major |
A. thermomutans |
A. sydowii |
Immunocompromised |
Pan-susceptible |
52% |
I/V amphotericin B, oral voriconazole, posaconazole |
Right parietal craniotomy, excision of abscess |
Died |
I/V, Intravenous.