{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T10:00:39Z","timestamp":1789207239868,"version":"build-2803163510"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2013,3,23]],"date-time":"2013-03-23T00:00:00Z","timestamp":1363996800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>\n              <jats:italic>Penicillium<\/jats:italic> species are among the most common fungi present in the environment and are usually considered non-pathogenic to humans. However, in immunocompromised hosts they can be virulent pathogens and can cause death. <jats:italic>Penicillium digitatum<\/jats:italic> is a plant pathogen that commonly causes a postharvest fungal disease of citrus called green mould; it very rarely causes systemic mycosis in humans. Here, we report a case of fatal pneumonia due to <jats:italic>P. digitatum<\/jats:italic> infection, as confirmed by repeated examination of cultured sputum.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>A cavity was found in the left upper lung on routine chest X-ray in a 78-year-old undernourished male who had been diagnosed at age 66 with bronchial asthma and pulmonary emphysema. No increased sputum production was present. The presence of antigen-specific precipitating antibodies to <jats:italic>Aspergillus flavus<\/jats:italic> and <jats:italic>P. digitatum<\/jats:italic> was confirmed in the patient\u2019s serum and also later pleural fluid by using Ouchterlony double immunodiffusion testing with <jats:italic>A. flavus<\/jats:italic> and <jats:italic>P. digitatum<\/jats:italic> antigens. The patient was treated over a period of months with itraconazole, micafungin, voriconazole, amphotericin B, and antibacterials. However, the cavity enlarged, the pleural effusion increased, and the patient began producing purulent sputum. He died from progressive renal failure. From sputum culture only one fungus was isolated repeatedly on potato-dextrose agar in large quantities. This fungus was confirmed to be <jats:italic>P. digitatum<\/jats:italic> by molecular identification. Partial sequences of the beta-tubulin gene were determined by using the primers Bt2a and Bt2b for PCR amplification and sequencing and underwent a BLAST search at the National Centre for Biotechnology Information, these results confirmed that the isolated fungus was <jats:italic>P. digitatum<\/jats:italic>.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>To our knowledge, this is the first report of pulmonary infection with <jats:italic>P. digitatum<\/jats:italic>. Our patient had pulmonary emphysema and was elderly, and undernourished. These factors might have facilitated the infection. In his case, antimycotics were ineffective in treating the lung involvement. Although human infection with <jats:italic>P. digitatum<\/jats:italic> is considered rare, it appears that this organism can be very virulent and resistant to antimycotics.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2466-13-16","type":"journal-article","created":{"date-parts":[[2013,3,23]],"date-time":"2013-03-23T09:14:16Z","timestamp":1364030056000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Fatal pneumonia caused by Penicillium digitatum: a case report"],"prefix":"10.1186","volume":"13","author":[{"given":"Chiyako","family":"Oshikata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Tsurikisawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akemi","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maiko","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichi","family":"Kamata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maki","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Tsuburai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Mitomi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Takatori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Yasueda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Akiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2013,3,23]]},"reference":[{"key":"389_CR1","first-page":"386","volume-title":"Penicillium digitatum. A Manual of the Penicillia","author":"KB Raper","year":"1968","unstructured":"Raper KB, Thom C: Penicillium digitatum. A Manual of the Penicillia. 1968, New York: Hafner Publ. Co, 386-392."},{"key":"389_CR2","doi-asserted-by":"crossref","first-page":"2654","DOI":"10.1128\/jcm.35.10.2654-2656.1997","volume":"35","author":"T Mok","year":"1997","unstructured":"Mok T, Koehler AP, Yu MY, Ellis DH, Johnson PJ, Wickham NW: Fatal Penicillium citrinum pneumonia with pericarditis in a patient with acute leukemia. J Clin Microbiol. 1997, 35: 2654-2656.","journal-title":"J Clin Microbiol"},{"key":"389_CR3","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1053\/jinf.2002.1056","volume":"45","author":"G Lyratzopoulos","year":"2005","unstructured":"Lyratzopoulos G, Ellis M, Nerringer R, Denning DW: Invasive infection due to Penicillium species other than P. marneffei. J Infection. 2005, 45: 184-207.","journal-title":"J Infection"},{"issue":"4","key":"389_CR4","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1111\/j.1699-0463.1949.tb00751.x","volume":"26","author":"O Ouchterlony","year":"1949","unstructured":"Ouchterlony O: Antigen-antibody reactions in gels. Acta Pathol Microbiol Scand. 1949, 26 (4): 507-515.","journal-title":"Acta Pathol Microbiol Scand"},{"key":"389_CR5","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1128\/aem.61.4.1323-1330.1995","volume":"61","author":"NL Glass","year":"1995","unstructured":"Glass NL, Donaldson GC: Development of primer sets designed for use with the PCR to amplify conserved genes from filamentous ascomycetes. Appl Environ Microbiol. 1995, 61: 1323-1330.","journal-title":"Appl Environ Microbiol"},{"key":"389_CR6","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1094\/PHYTO.1999.89.9.716","volume":"89","author":"LG Holmes","year":"1999","unstructured":"Holmes LG, Eckert JW: Sensitivity of Penicillium digitatum and P. italicum to postharvest citrus fungicides in California. Phytopathology. 1999, 89: 716-721. 10.1094\/PHYTO.1999.89.9.716.","journal-title":"Phytopathology"},{"key":"389_CR7","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1159\/000237283","volume":"110","author":"J Brouwer","year":"1996","unstructured":"Brouwer J: Cross-reactivity between Aspergillus fumigatus and Penicillium. Int Arch Allergy Immunol. 1996, 110: 166-173. 10.1159\/000237283.","journal-title":"Int Arch Allergy Immunol"},{"key":"389_CR8","doi-asserted-by":"crossref","first-page":"3335","DOI":"10.1128\/jcm.35.12.3335-3337.1997","volume":"35","author":"D D\u2019Antonio","year":"1997","unstructured":"D\u2019Antonio D, Violante B, Farina C, Sacco R, Angelucci D, Masciulli M, Iacone A, Romano F: Necrotizing pneumonia caused by Penicillium chrysogenum. J Clin Microbiol. 1997, 35: 3335-3337.","journal-title":"J Clin Microbiol"},{"key":"389_CR9","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1097\/00007611-199006000-00029","volume":"83","author":"MS Gelfand","year":"1990","unstructured":"Gelfand MS, Cole FH, Baskin RC: Invasive pulmonary penicilliosis: successful therapy with amphotericin B. South Med J. 1990, 83: 701-704. 10.1097\/00007611-199006000-00029.","journal-title":"South Med J"},{"key":"389_CR10","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1007\/s00277-008-0606-5","volume":"88","author":"JH Hsu","year":"2009","unstructured":"Hsu JH, Lee MS, Dai ZK: Life-threatening airway obstruction caused by penicilliosis in a leukemic patient. Ann Hematol. 2009, 88: 393-395. 10.1007\/s00277-008-0606-5.","journal-title":"Ann Hematol"},{"key":"389_CR11","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1378\/chest.120.1.177","volume":"120","author":"KY Chen","year":"2001","unstructured":"Chen KY, Ko SC, Hsueh PR, Luh KT, Yang PC: Pulmonary fungal infection. Emphasis on microbiological spectra, patient outcome and prognostic factors. Chest. 2001, 120: 177-10.1378\/chest.120.1.177.","journal-title":"Chest"},{"key":"389_CR12","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1128\/AAC.46.4.1032-1037.2002","volume":"46","author":"MA Pfaller","year":"2002","unstructured":"Pfaller MA, Messer SA, Hollis RJ, Jones RN, SENTRY Participants Group: Antifungal activities of posaconazole, ravuconazole, and voriconazole compared to those of itraconazole and amphotericin B against 239 clinical isolates and Aspergillus spp. and other filamentous fungi: report from SENTRY antimicrobial surveillance program, 2000. Antimicrob Agents Chemother. 2002, 46: 1032-1037. 10.1128\/AAC.46.4.1032-1037.2002.","journal-title":"Antimicrob Agents Chemother"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2466-13-16.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-2466-13-16\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2466-13-16","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2466-13-16.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T22:48:51Z","timestamp":1630536531000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpulmmed.biomedcentral.com\/articles\/10.1186\/1471-2466-13-16"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3,23]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["389"],"URL":"https:\/\/doi.org\/10.1186\/1471-2466-13-16","relation":{},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3,23]]},"assertion":[{"value":"14 October 2012","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 March 2013","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 March 2013","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"16"}}