SYSTEMIC ASPERGILLOSIS CAUSED BY AN AFLATOXIN-PRODUCING STRAIN OF ASPERGILLUS-FLAVUS

The first case of human systemic infection by an Aspergillus flavus is olate demonstrated to produce aflatoxins in vitro and in vivo is descr ibed. The patient, a 41-year-old man with acute myelogenous leukaemia, developed a complication of suspected pulmonary Aspergillus infection during remission induction therapy. Antifungal chemotherapy brought a bout a considerable degree of improvement, but remission of the underl ying disease was not attained.:Bone marrow transplantation was also no t effective. The patient showed recovery from neutropenia but died des pite aggresive antifungal chemotherapy. The autopsy revealed lesions i n the lungs, myocardium, kidneys, brain, thyroid gland and skin due to a suspected Aspergillus sp. A fungus isolated from the right lung and the skin lesions was identified as A. flavus. Aflatoxins B-1, B-2 and M-1 were detected in culture filtrates of the isolated A. fluvus, and in an extract of lung lesions. These aflatoxins are considered to hav e played an important role in damaging the immune system of the patien t through their toxic effects.