Abstract:

Objective

To explore the diagnostic characteristics of invasive pulmonary fungal infection（IPFI）caused by Alternaria spp.

Methods

The clinical data of a patient with IPFI caused by Alternaria spp. infection， diagnosed and treated in the Pulmonary and Critical Care Medicine Department of Western Theater General Hospital on May 31， 2024 were retrospectively analyzed， and relevant literature was reviewed.

Results

The patient was an 84-year-old female who presented with cough， sputum production，and left-sided chest pain. Chest CT showed multiple patchy and exudative lesions in both lungs. Conventional anti-infection treatment was ineffective， with no significant absorption of the lesions. Bronchoscopy revealed no abnormalities， but metagenomic next-generation sequencing （mNGS） of the lavage fluid identified Alternaria spp. as the pathogen. The patient was treated with nebulized amphotericin B combined with intravenous voriconazole for antifungal therapy. After 10 days of treatment， symptoms significantly improved，and follow-up chest CT showed slight absorption of the lesions. After discharge， the patient continued taking oral voriconazole. Three months later， the patient′s cough， sputum production， and chest pain completely resolved， with chest CT showed significant absorption of the lesions.

Conclusion

mNGS can effectively diagnose IPFI caused by Alternaria spp.， and the combination of amphotericin B and voriconazole can achieve favorable therapeutic outcomes.

Key words: Alternaria spp., Invasive pulmonary fungal infection, Voriconazole, Amphotericin B