Abstract:

Liu Fang, Kong Qingtao, Zhang Caiyun, Sang Hong, Shen Yongnian, Lyu Guixia, Liu Weida, Shi Yi Department of Dermatology, Nanjing General Hospital/Nanjing General Hospital Affiliated to Nanjing University, Nanjing 210002, China （Liu F, Kong QT, Zhang CY, Sang H）; Department of Pneumology, Nanjing General Hospital of Nanjing Military Command, Nanjing 210002, China （Shi Y）; Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China （Shen YN, Lyu GX, Liu WD） Corresponding author: Sang Hong, Email: shzwqzsl@163.com 【Abstract】 A 76?year?old female patient complained of right chest pain for three months. CT scan showed a clump?like high?density shadow measuring 4.8 cm × 3.0 cm in size in the dorsal portion of the right lower lobe of the lung. Aspiration biopsy was performed, and biopsy samples were subjected to fungal culture and histopathological examination. Histopathological examination showed chronic granulomatous inflammation with hyaline septate hyphae. After 4?day culture, white villous dense colonies were formed on the Sabouraud′s agar medium. The center of the colonies was slightly elevated with wrinkles or radiating striae on the surface, and the bottom of the colonies was faint yellow in color. Microculture yielded abundant septate branched hyphae, and very few colorless hyaline quasi?circular spores. DNA sequencing of rDNA internal transcribed spacer （ITS） regions and β?tubulin genes was performed to identify the isolate, and antifungal susceptibility testing was carried out in vitro. The MEGA7.0 software was used to build phylogenetic trees of Aspergillus fumigatus complex and its closely related species. The isolate was identified as Aspergillus fumigatus by molecular biologic sequencing. The patient was diagnosed with pulmonary aspergilloma. After administration of itraconazole oral solution and vorionazole tablets, the condition got better obviously.