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Contrast-enhanced computed tomography of the chest revealed bilateral cystic bronchiectasis with multiple cavitary nodules. Ultrasonography of the abdomen revealed extrahepatic biliary obstruction, likely carcinomatous in etiology. She was started on antibiotics and percutaneous transhepatic biliary drainage was done. The patient had to be intubated owing to worsening respiratory function. Antifungals were added subsequently due to raised galactomannan levels, but the patient died due to refractory hypokalemia. Postmortem lung biopsy sample showed septate hyphae on direct microscopy. The culture of the mini-bronchoalveolar lavage sample, as well as postmortem lung biopsy, grew a dematiaceous mold. Sequencing of the internal transcribed spacer region of the 18S ribosomal DNA identified the isolate to be Acrophialophora angustiphialis.<\/jats:p>","DOI":"10.1093\/ofid\/ofaf182","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T17:32:37Z","timestamp":1744133557000},"source":"Crossref","is-referenced-by-count":1,"title":["Expanding Epidemiology: A Case of Pulmonary Disease Caused by <i>Acrophialophora angustiphialis<\/i>"],"prefix":"10.1093","volume":"12","author":[{"given":"Kavi Priya","family":"Appasami","sequence":"first","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudesh","family":"Gourav","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2367-4636","authenticated-orcid":false,"given":"Srinivas","family":"Mani","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjoli","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Immaculata","family":"Xess","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7904-4409","authenticated-orcid":false,"given":"Manish","family":"Soneja","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naval K","family":"Vikram","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Himanshu","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonakshi","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhaskar","family":"Rana","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mragnayani","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3169-8419","authenticated-orcid":false,"given":"Gagandeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences , New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"2025052712082745600_ofaf182-B1","first-page":"e37614","article-title":"Acrophialophora: a comprehensive review of clinical guidelines and diagnosis","volume":"15","author":"Bhattaru","year":"2023","journal-title":"Cureus"},{"key":"2025052712082745600_ofaf182-B2","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1128\/JCM.00279-15","article-title":"Acrophialophora, a poorly known fungus with clinical significance","volume":"53","author":"Sandoval-Denis","year":"2015","journal-title":"J Clin Microbiol"},{"key":"2025052712082745600_ofaf182-B3","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1080\/00362178385380211","article-title":"Clinical and experimental keratitis caused by the Colletotrichum state of Glomerella cingulata and Acrophialophora fusispora","volume":"21","author":"Shukla","year":"1983","journal-title":"Sabouraudia"},{"key":"2025052712082745600_ofaf182-B4","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.diagmicrobio.2007.04.001","article-title":"Acrophialophora fusispora: an emerging agent of human mycoses. 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