{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:12:26Z","timestamp":1790241146677,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100001949","name":"American Society of Tropical Medicine and Hygiene","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001949","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Both pulmonary tuberculosis (PTB) and coronavirus disease\u20102019 (COVID\u201019) are risk factors for chronic pulmonary aspergillosis (CPA) and other pulmonary infectious diseases because of residual lung damage. We report a case of\n                    <jats:italic>Achromobacter<\/jats:italic>\n                    spp. infection following CPA in an immunocompetent woman with a history of PTB and COVID\u201019. A 63\u2010year\u2010old Cameroonian woman presented in November 2021 with a history of cough with productive muco\u2010purulent sputum, asthenia, headaches, and chest pain for 8\u2009weeks. There was no history of hemoptysis or difficulty in breathing. She was treated for PTB in 2002 and COVID\u201019 in 2020 and had no other underlying co\u2010morbidities. Chest X\u2010ray showed bronchiectasis in the right lung and features of healed PTB. SARS\u2010CoV\u20102 antigen, antibody, and real\u2010time polymerase chain reaction tests were negative. Microscopy and GeneXpert MTB\/RIF on the sputum sample were both negative. Sputum samples grew\n                    <jats:italic>Aspergillus flavus<\/jats:italic>\n                    complex and\n                    <jats:italic>Aspergillus niger<\/jats:italic>\n                    complex, and serum\n                    <jats:italic>Aspergillus<\/jats:italic>\n                    \u2010specific IgG\u2010IgM antibody was positive, suggestive of CPA. She showed significant clinical improvement on itraconazole tablets 200\u2009mg (every 12\u2009h) after 4\u2009months of therapy. She presented 1\u2009month later with severe symptomatic relapse and elevated white blood cells (27,000\u2009cells\/\u03bcL). Antibiotic therapy with amoxicillin\u2009+\u2009clavulanic acid and subsequently with ceftriaxone was unsuccessful. Chest CT scan showed a middle right mediastinal tissue mass with crenulated edges. Bronchoalveolar lavage (BAL) and lung biopsy testing yielded a negative result for PTB, invasive aspergillosis, and lung cancer. However, the BAL sample grew\n                    <jats:italic>Achromobacter<\/jats:italic>\n                    spp. She was initiated on imipenem 1\u2009g (3\u2009g\/day\u2009\u00d7\u200910\u2009days) with resolution of symptoms. This case suggests that because of the high burden of TB and COVID\u201019 in Cameroon, pulmonary bacterial and fungal superinfections are underreported. CPA is presently undiagnosed and underreported in Cameroon. Further investigations should be performed in patients not responding to usual antibiotics.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.71121","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T03:49:01Z","timestamp":1759808941000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronic Pulmonary Aspergillosis Secondary Infection: A Case Report of\n                    <i>Achromobacter<\/i>\n                    spp. Lung Infection"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2745-0450","authenticated-orcid":false,"given":"Marius Paulin Ngouanom","family":"Kuate","sequence":"first","affiliation":[{"name":"Department of Microbiology and Parasitology, Faculty of Science University of Buea  Buea Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4515-8517","authenticated-orcid":false,"given":"Felix","family":"Bongomin","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine Gulu University  Gulu Uganda"},{"name":"Manchester Fungal Infection Group, Faculty of Biology, School of Biological Sciences, Medicine and Health The University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-2251","authenticated-orcid":false,"given":"David W.","family":"Denning","sequence":"additional","affiliation":[{"name":"Manchester Fungal Infection Group, Faculty of Biology, School of Biological Sciences, Medicine and Health The University of Manchester  Manchester UK"},{"name":"The Global Action for Fungal Infections  Gen\u00e8ve Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8122037"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00140-18"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-021-02721-9"},{"key":"e_1_2_12_5_1","unstructured":"\u201cTB profile [Internet] \u201d[cited 2024 Jun 30] https:\/\/worldhealthorg.shinyapps.io\/tb_profiles\/?_inputs_&entity_type=%22country%22&iso2=%22CM%22&lan=%22EN%22."},{"key":"e_1_2_12_6_1","unstructured":"\u201cTB profile [Internet] \u201d[cited 2024 Jun 30] https:\/\/worldhealthorg.shinyapps.io\/tb_profiles\/?_inputs_&group_code=%22AFR%22&entity_type=%22group%22&lan=%22EN%22."},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01184-2018"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.11.089441"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2021.105865"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2704.204895"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/1329884"},{"issue":"1","key":"e_1_2_12_12_1","first-page":"018","article-title":"Aspergilloma in Post COVID\u201019 Patient","volume":"7","author":"Kumar A.","year":"2021","journal-title":"Archives of Pulmonology and Respiratory Care"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof6040346"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1008742"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00692-8"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof7070532"},{"key":"e_1_2_12_17_1","volume-title":"StatPearls [Internet]","author":"Evans J.","year":"2025"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2014.03.003"},{"key":"e_1_2_12_19_1","unstructured":"\u201cAzithromycin [Internet] \u201dhttps:\/\/go.drugbank.com\/drugs\/DB00207."},{"key":"e_1_2_12_20_1","volume-title":"StatPearls [Internet]","author":"Chaves B. J.","year":"2025"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics13040305"},{"key":"e_1_2_12_22_1","unstructured":"American Osteopathic College of Dermatology (AOCD) \u201cItraconazole [Internet] \u201dhttps:\/\/www.aocd.org\/page\/Itraconazole."},{"key":"e_1_2_12_23_1","volume-title":"StatPearls [Internet]","author":"Kurn H.","year":"2025"},{"key":"e_1_2_12_24_1","unstructured":"\u201cImipenem [Internet] \u201dhttps:\/\/go.drugbank.com\/drugs\/DB01598."},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-021-01471-8"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkl354"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micres.2022.127140"},{"key":"e_1_2_12_28_1","doi-asserted-by":"crossref","unstructured":"C. E.Billiot M. S.McDaniel N. R.Lindgren andW. E.Swords \u201cPathogenesis ofAchromobacter xylosoxidansRespiratory Infections: Colonization and Persistence of Airway Epithelia and Differential Gene Expression in Synthetic Cystic Fibrosis Sputum Medium \u201dbioRxiv 2023 2023.04.04.535650.","DOI":"10.1101\/2023.04.04.535650"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.4103\/mgmj.mgmj_41_23"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijabmr.ijabmr_520_22"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.22207\/JPAM.17.4.11"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/23247096211063332"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof4020044"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2408.171312"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-024-04755-5"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11243151"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxics11020185"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-021-00649-x"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s44259-024-00026-7"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71121","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.71121","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:54:17Z","timestamp":1790240057000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.71121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":38,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/ccr3.71121"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.71121","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2024-10-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71121"}}