Skip to main content

REVIEW article

Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1413964

Rapid diagnosis of Aspergillus flavus infection in acute very severe aplastic anemia with metagenomic next-generation sequencing: a case report and literature review

Provisionally accepted
Ying Kang Ying Kang 1Xiaojing Zhang Xiaojing Zhang 2Cao Qin Cao Qin 3Yafeng Zheng Yafeng Zheng 2Wei Gai Wei Gai 2Xiaofei Jia Xiaofei Jia 3Bo Shao Bo Shao 3Shuai Zhang Shuai Zhang 3Hao Jiang Hao Jiang 1,3Xiaojun Huang Xiaojun Huang 1,3Jinsong Jia Jinsong Jia 1,3*
  • 1 Department of Hematology, Peking University People's Hospital, Beijing, China
  • 2 WillingMed Technology (Beijing) Co.Ltd, Beijing, China
  • 3 Beijing Qinghe Hospital, Beijing, China

The final, formatted version of the article will be published soon.

    Infection remains the leading cause of mortality in severe aplastic anemia (SAA) patients, with invasive fungal infections being the great threat. Aspergillus fumigatus accounts for most of the reported fungal infection cases. Here, we present a case of A. flavus infection in a patient with acute very severe aplastic anemia (VSAA) despite persistently negative clinical fungal tests. The patient was admitted to the hospital due to pancytopenia presisting for over a month and intermittent fever for 10 days. Elevated inflammatory indicators and abnormal lung imaging suggested infection, prompting consideration of fungal involvement. Despite negative results from multiple blood, sputum fungal cultures and the serum (1,3)-β-D-glucan/ galactomannan tests. Metagenomic nextgeneration sequencing (mNGS) on multiple blood samples, alongside clinical symptoms, confirmed A. flavus infection. Targeted antifungal treatment with liposomal amphotericin B and voriconazole significantly ameliorated pulmonary symptoms. Additionally, this study reviewed and compared the symptoms, diagnostic approaches, and treatments from prior Aspergillus infections in AA patients. It emphasizes critical role of early mNGS utilization in diagnosing and managing infectious diseases, offering insights for diagnosing and treating fungal infections in VSAA.

    Keywords: Aspergillus flavus, Invasive fungal infection, aplastic anemia, metagenomic nextgeneration sequencing, blood were negative

    Received: 11 May 2024; Accepted: 26 Aug 2024.

    Copyright: © 2024 Kang, Zhang, Qin, Zheng, Gai, Jia, Shao, Zhang, Jiang, Huang and Jia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jinsong Jia, Department of Hematology, Peking University People's Hospital, Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.