Doctors at the All Indian Institute of Medical Sciences in New Delhi have confirmed the presence of a drug-resistant pathogen called Aspergillus Lentulus in two patients suffering from pulmonary issues.
According to The Times of India, both patients — one in their 50s and the other in their 40s — were suffering from chronic obstructive pulmonary disease (COPD). They were admitted to AIIMS Delhi according to a case report published in the Indian Journal of Medical Microbiology (IJMM).
Both the patients had COPD, and neither of them seemed to respond to the antibiotic or antifungal treatment they were administered. Both died during the treatment.
The patients were given Amphotericin B and oral Voriconazole injections at AIIMS, but there was no improvement in their healths and they ultimately succumbed to the fungal infection.
What is Aspergillus Lentulus?
According to the US Centre for Disease Control and Prevention (CDC). Aspergillus Lentulus is a type of species of fungus that can cause invasive aspergillosis, a serious infection that typically affects the lungs and has a high fatality rate.
It is caused by Aspergillus, a common mold (a type of fungus) that lives indoors and outdoors. Most people breathe in Aspergillus spores every day without getting sick.
Since this is the first time such cases have been reported in India, experts have urged caution. There are different types of aspergillosis. Some types are mild, but some of them are very serious.
What are its symptoms?
According to MayoClinic, the signs and symptoms of aspergillosis vary with the type of illness you develop.
But here are typical symptoms of Invasive pulmonary aspergillosis — the most severe form of aspergillosis.
- Fever
- Cough
- Coughing up blood
- Fatigue
- Shortness of breath
- Chest pain
Who gets Aspergillus?
Aspergillus mold is unavoidable. Outdoors, it's found in decaying leaves and compost and on plants, trees and grain crops.
Everyday exposure to aspergillus is rarely a problem for people with healthy immune systems. When mold spores are inhaled, immune system cells surround and destroy them. But people who have a weakened immune system from illness or immunosuppressant medications have fewer infection-fighting cells. This allows aspergillus to take hold, invading the lungs and, in the most serious cases, other parts of the body.
Aspergillosis is not contagious from person to person.
The different types of aspergillosis affect different groups of people.
- Allergic bronchopulmonary aspergillosis (ABPA) most often occurs in people who have cystic fibrosis or asthma.
- Aspergillomas usually affect people who have other lung diseases like tuberculosis. Also called a “fungus ball.”
- Chronic pulmonary aspergillosis typically occurs in people who have other lung diseases, including tuberculosis, chronic obstructive pulmonary disease (COPD), or sarcoidosis.
- Invasive aspergillosis affects people who have weakened immune systems, such as people who have had a stem cell transplant or organ transplant, are getting chemotherapy for cancer, or are taking high doses of corticosteroids. Invasive aspergillosis has been described among hospitalized patients with severe influenza.
The risk of developing aspergillosis depends on a person's overall health and the extent of exposure. In general, these factors make you more vulnerable to infection:
- Weakened immune system
- Low white blood cell level
- Lung cavities
- Asthma or cystic fibrosis
- Long-term corticosteroid therapy
Treatment: What do we know so far and do we need to worry
It's nearly impossible to avoid exposure to aspergillus, but if a person has had a transplant or is undergoing chemotherapy, they must try to stay away from places where you're likely to encounter mold, such as construction sites.
What's particularly worrying about these cases is that the pathogen doesn't seem to be responding to antifungal treatments. As per the CDC, antifungal resistance takes place when a fungus is able to survive even though the patient is being treated with antifungal medications.
For a while now, doctors have spoken of antibiotic overuse and steroid misuse as possibly being behind the rise in antimicrobial-resistant pathogens around the world. Antibiotic resistance is putting the achievements of modern medicine at risk.
When infections can no longer be treated by first-line antibiotics, more expensive medicines must be used. A longer duration of illness and treatment, often in hospitals, increases health care costs as well as the economic burden on families and societies.
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