{"doi":"10.1002/jcla.24971","title":"Central nervous system <i>Aspergillus quadrilineatus</i> infection in a <scp>COVID</scp>‐19 patient, a case report and literature review","abstract":"BACKGROUND: Viral pneumonia such as COVID-19-associated aspergillosis could increase susceptibility to fungal super-infections in critically ill patients. METHODS: Here we report a pediatric case of Aspergillus quadrilineatus cerebral infection in a recently diagnosed COVID-19-positive patient underlying acute lymphocytic leukemia. Morphological, molecular methods, and sequencing were used to identify this emerging species. RESULTS: Histopathological examination showed a granulomatous necrotic area containing dichotomously branching septate hyphae indicating a presumptive Aspergillus structure. The species-level identity of isolate growing on brain biopsy culture was confirmed by PCR sequencing of the β-tubulin gene as A. quadrilineatus. Using the CLSI M38-A3 broth microdilution methodology, the in vitro antifungal susceptibility testing demonstrated 0.032 μg/mL MIC for posaconazole, caspofungin, and anidulafungin and 8 μg/mL against amphotericin B. A combination of intravenous liposomal amphotericin B and caspofungin therapy for 8 days did not improve the patient's condition. The patient gradually continued to deteriorate and expired. CONCLUSIONS: This is the first COVID-19-associated cerebral aspergillosis due to A. quadrilineatus in a pediatric patient with acute lymphocytic leukemia. However, comprehensive screening studies are highly recommended to evaluate its frequency and antifungal susceptibility profiles. Before being recommended as first-line therapy in high-risk patients, more antifungal susceptibility data are needed.","journal":"Journal of Clinical Laboratory Analysis","year":2023,"id":381186,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9582,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1146714,"name":"Mona Ghazanfari","orcid":"0000-0002-3045-9125","position":1,"is_corresponding":false},{"id":48466,"name":"Javad Javidnia","orcid":"0000-0001-9336-2518","position":2,"is_corresponding":false},{"id":1146715,"name":"Mahdi Abastabar","orcid":"0000-0002-0016-2849","position":3,"is_corresponding":false},{"id":1146716,"name":"Mohammad Taghi Haghi Ashtıani","orcid":"0000-0002-8436-4420","position":4,"is_corresponding":false},{"id":1146717,"name":"Maryam Sotoudeh Anvari","orcid":"0000-0003-2318-8571","position":5,"is_corresponding":false},{"id":1147179,"name":"Maryam Fathi","orcid":null,"position":6,"is_corresponding":false},{"id":1146718,"name":"Amirreza Espahbodi","orcid":"0000-0003-4297-3970","position":7,"is_corresponding":false},{"id":61050,"name":"Hamid Badali","orcid":"0000-0002-6010-8414","position":8,"is_corresponding":false},{"id":445909,"name":"Mohammad Taghi Hedayati","orcid":"0000-0001-6415-4648","position":9,"is_corresponding":false},{"id":1146719,"name":"Iman Haghani","orcid":"0000-0001-9723-7618","position":10,"is_corresponding":false},{"id":61356,"name":"Seyedmojtaba Seyedmousavi","orcid":"0000-0002-6194-7447","position":11,"is_corresponding":false},{"id":1147178,"name":"Kazem Amirizad","orcid":null,"position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":null,"created_at":"2026-07-19T01:17:08.831117Z","pmid":"37798858","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}