Uncommon Concurrent Pulmonary Infections: and in an Anti-MDA5 Antibody-positive Dermatomyositis Patient

Overview

Journal Med Mycol Case Rep

Publisher Elsevier

Date 2025 Jan 6

PMID 39760058

Authors

Maaya Fukumura

Ryosuke Hiwa

Satomi Yukawa

Yasuhiro Tsuchido

Hajime Yoshifuji

Akio Morinobu

Affiliations

Soon will be listed here.

Abstract

A 59-year-old female with anti-MDA5 antibody-positive dermatomyositis was treated with prednisolone, tacrolimus, cyclophosphamide, tofacitinib, and plasma exchange. Five months post-treatment, elevated β-D-glucan levels and a pulmonary shadow on CT were noted. was identified, leading to voriconazole initiation. A new pulmonary cavity lesion later revealed . Considering voriconazole resistance, terbinafine was added, resulting in clinical improvement. Vigilant infection monitoring is crucial during anti-MDA5 antibody-positive dermatomyositis treatment.

References

Hoenigl M, Salmanton-Garcia J, Walsh T, Nucci M, Neoh C, Jenks J . Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for.... Lancet Infect Dis. 2021; 21(8):e246-e257. DOI: 10.1016/S1473-3099(20)30784-2. View

Chen Z, Cao M, Plana M, Liang J, Cai H, Kuwana M . Utility of anti-melanoma differentiation-associated gene 5 antibody measurement in identifying patients with dermatomyositis and a high risk for developing rapidly progressive interstitial lung disease: a review of the literature and a meta-analysis. Arthritis Care Res (Hoboken). 2013; 65(8):1316-24. DOI: 10.1002/acr.21985. View

Shirakashi M, Nakashima R, Tsuji H, Tanizawa K, Handa T, Hosono Y . Efficacy of plasma exchange in anti-MDA5-positive dermatomyositis with interstitial lung disease under combined immunosuppressive treatment. Rheumatology (Oxford). 2020; 59(11):3284-3292. DOI: 10.1093/rheumatology/keaa123. View

Chen S, Halliday C, Hoenigl M, Cornely O, Meyer W . .... J Fungi (Basel). 2021; 7(1). PMC: 7823285. DOI: 10.3390/jof7010023. View

Pace C, Frankenhoff J, Isaacs J . Septic Arthritis. J Hand Microsurg. 2017; 9(1):37-38. PMC: 5403730. DOI: 10.1055/s-0036-1597553. View

Lee J, Wilson M, Casey N . Eradication of Osteomyelitis of the Wrist with Combination Antifungal Therapy, Voriconazole Bone Cement, and Surgical Debridement. Case Rep Orthop. 2020; 2020:8271471. PMC: 7519977. DOI: 10.1155/2020/8271471. View

Billet A, Barba T, Coutant F, Fabien N, Perard L, Seve P . Infection Risk in Patients with Dermatomyositis Associated with Anti-MDA5 Antibodies: A Historical Cohort Study. Biomedicines. 2022; 10(12). PMC: 9776099. DOI: 10.3390/biomedicines10123176. View

Seidel D, Meissner A, Lackner M, Piepenbrock E, Salmanton-Garcia J, Stecher M . Prognostic factors in 264 adults with invasive Scedosporium spp. and Lomentospora prolificans infection reported in the literature and FungiScope. Crit Rev Microbiol. 2019; 45(1):1-21. DOI: 10.1080/1040841X.2018.1514366. View

Koga T, Fujikawa K, Horai Y, Okada A, Kawashiri S, Iwamoto N . The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM. Rheumatology (Oxford). 2012; 51(7):1278-84. DOI: 10.1093/rheumatology/ker518. View

10.

Rammaert B, Puyade M, Cornely O, Seidel D, Grossi P, Husain S . Perspectives on Scedosporium species and Lomentospora prolificans in lung transplantation: Results of an international practice survey from ESCMID fungal infection study group and study group for infections in compromised hosts, and European.... Transpl Infect Dis. 2019; 21(5):e13141. DOI: 10.1111/tid.13141. View

11.

Wu Y, Grossman N, Totten M, Memon W, Fitzgerald A, Ying C . Antifungal Susceptibility Profiles and Drug Resistance Mechanisms of Clinical Lomentospora prolificans Isolates. Antimicrob Agents Chemother. 2020; 64(11). PMC: 7577128. DOI: 10.1128/AAC.00318-20. View

12.

Sugiura Y, Sugimoto N, Takahashi T, Matsumoto T . Dual fungal infection with and : A pathogenetic diagnosis elucidated after two decades by sequential examinations. Clin Case Rep. 2021; 9(3):1383-1386. PMC: 7981601. DOI: 10.1002/ccr3.3775. View

13.

Jenks J, Seidel D, Cornely O, Chen S, Van Hal S, Kauffman C . Voriconazole plus terbinafine combination antifungal therapy for invasive Lomentospora prolificans infections: analysis of 41 patients from the FungiScope® registry 2008-2019. Clin Microbiol Infect. 2020; 26(6):784.e1-784.e5. DOI: 10.1016/j.cmi.2020.01.012. View

14.

Kurasawa K, Arai S, Namiki Y, Tanaka A, Takamura Y, Owada T . Tofacitinib for refractory interstitial lung diseases in anti-melanoma differentiation-associated 5 gene antibody-positive dermatomyositis. Rheumatology (Oxford). 2018; 57(12):2114-2119. DOI: 10.1093/rheumatology/key188. View

15.

Wang H, Chen X, Du Y, Wang L, Wang Q, Wu H . Mortality risk in patients with anti-MDA5 dermatomyositis is related to rapidly progressive interstitial lung disease and anti-Ro52 antibody. Arthritis Res Ther. 2023; 25(1):127. PMC: 10367378. DOI: 10.1186/s13075-023-03100-z. View

16.

Nakashima R, Hosono Y, Mimori T . Clinical significance and new detection system of autoantibodies in myositis with interstitial lung disease. Lupus. 2016; 25(8):925-33. DOI: 10.1177/0961203316651748. View

17.

Erami M, Mirhendi H, Momen-Heravi M, Sharif A, Hashemi Hezaveh S, Matini A . Case report: COVID-19-associated mucormycosis co-infection with : The first case and review on multiple fungal co-infections during COVID-19 pandemic. Front Med (Lausanne). 2023; 10:1078970. PMC: 10061085. DOI: 10.3389/fmed.2023.1078970. View