{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T05:08:23Z","timestamp":1780376903677,"version":"3.54.1"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    <jats:italic>Aspergillus lentulus<\/jats:italic>\n                    is a slow-growing and drug-resistant fungus, which has been primarily reported in adults, usually immunocompromised ones, suffering from invasive pulmonary aspergillosis (IPA). This condition is rare in children. Here, we report a case of invasive pulmonary aspergillosis due to\n                    <jats:italic>Aspergillus lentulus<\/jats:italic>\n                    in a boy with no history of recurrent infections who presented with a prolonged fever of unknown origin. Based on chest CT scan findings showing typical halo signs, a fungal infection was strongly suspected. Empirical antifungal therapy was initiated at early admission but failed to resolve the persistent fever in this case. The causative pathogen was confirmed by blood metagenomic next-generation sequencing (mNGS). Subsequent genetic analysis identified a pathogenic mutation in the X-linked CYBB gene, confirming chronic granulomatous disease (CGD). Eventually, following a combination therapy of voriconazole and micafungin, the boy became afebrile and was discharged, pending hematopoietic stem cell transplantation (HSCT). To our knowledge, no previous cases of\n                    <jats:italic>Aspergillus lentulus<\/jats:italic>\n                    infection in children with CGD have been reported in the literature. This case underscores the critical importance of identifying the causative microorganism. It also highlights the value of emerging detection methods, such as mNGS. At present, there is no consensus for the optimal antifungal regimen against pediatric\n                    <jats:italic>Aspergillus lentulus<\/jats:italic>\n                    infections. Clinical improvement was achieved in this patient following combination therapy with voriconazole and micafungin, offering a practical therapeutic reference for managing this refractory fungal infection.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1813957","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:29:37Z","timestamp":1780374577000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Invasive pulmonary aspergillosis caused by Aspergillus lentulus in a boy with chronic granulomatous disease"],"prefix":"10.3389","volume":"13","author":[{"given":"Shan","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Pediatric Infectious Diseases, West China Second University Hospital","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, China"]},{"name":"NHC Key Laboratory of Chronobiology (Sichuan University)","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, West China Second University Hospital","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, China"]},{"name":"NHC Key Laboratory of Chronobiology (Sichuan University)","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, West China Second University Hospital","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, China"]},{"name":"NHC Key Laboratory of Chronobiology (Sichuan University)","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, West China Second University Hospital","place":["Chengdu, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education","place":["Chengdu, China"]},{"name":"NHC Key Laboratory of Chronobiology (Sichuan University)","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"1672","DOI":"10.3389\/fmicb.2020.01672","article-title":"Clinical and microbiological characterization of invasive pulmonary Aspergillosis caused by Aspergillus lentulus in China.","volume":"11","author":"Yu","year":"2020","journal-title":"Front Microbiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1128\/EC.4.3.625-632.2005","article-title":"Aspergillus lentulus sp. nov., a new sibling species of A. fumigatus.","volume":"4","author":"Balajee","year":"2005","journal-title":"Eukaryot Cell."},{"key":"B3","doi-asserted-by":"publisher","first-page":"ofab392","DOI":"10.1093\/ofid\/ofab392","article-title":"Aspergillus lentulus: an under-recognized cause of antifungal drug-resistant Aspergillosis.","volume":"8","author":"Nematollahi","year":"2021","journal-title":"Open Forum Infect Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1007\/s11046-014-9775-z","article-title":"Antifungal susceptibility profile of cryptic species of Aspergillus.","volume":"178","author":"Alastruey-Izquierdo","year":"2014","journal-title":"Mycopathologia."},{"key":"B5","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.jiac.2015.01.005","article-title":"Secondary metabolite profiles and antifungal drug susceptibility of Aspergillus fumigatus and closely related species, Aspergillus lentulus, Aspergillus udagawae, and Aspergillus viridinutans.","volume":"21","author":"Tamiya","year":"2015","journal-title":"J Infect Chemother."},{"key":"B6","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1006\/bcmd.2000.0347","article-title":"Hematologically important mutations: X-linked chronic granulomatous disease (second update).","volume":"27","author":"Heyworth","year":"2001","journal-title":"Blood Cells Mol Dis."},{"key":"B7","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.jiac.2019.02.003","article-title":"Invasive pulmonary aspergillosis due to Aspergillus lentulus in an adult patient: a case report and literature review.","volume":"25","author":"Yagi","year":"2019","journal-title":"J Infect Chemother."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1209724","DOI":"10.3389\/fcimb.2023.1209724","article-title":"Metagenomic next-generation sequencing for detecting Aspergillosis pneumonia in immunocompromised patients: a retrospective study.","volume":"13","author":"Shi","year":"2023","journal-title":"Front Cell Infect Microbiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1093\/bmb\/ldw009","article-title":"Chronic granulomatous disease.","volume":"118","author":"Roos","year":"2016","journal-title":"Br Med Bull."},{"key":"B10","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1093\/jpids\/piy008","article-title":"Chronic granulomatous disease: epidemiology, pathophysiology, and genetic basis of disease.","volume":"7","author":"Rier","year":"2018","journal-title":"J Pediatric Infect Dis Soc."},{"key":"B11","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1097\/INF.0000000000003109","article-title":"Hematopoietic stem cell transplantation cures therapy-refractory Aspergillosis in chronic granulomatous disease.","volume":"40","author":"Dedieu","year":"2021","journal-title":"Pediatr Infect Dis J."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1813957\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:29:38Z","timestamp":1780374578000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1813957\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,2]]},"references-count":11,"alternative-id":["10.3389\/fmed.2026.1813957"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1813957","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,2]]},"article-number":"1813957"}}