Jaroensawang W.Chongtrakool P.Chayakulkeeree M.Jitmuang A.Mahidol University2026-03-272026-03-272026-06-01Medical Mycology Case Reports Vol.52 (2026)22117539https://repository.li.mahidol.ac.th/handle/123456789/115848Invasive aspergillosis (IA) primarily affects immunocompromised patients, with Aspergillus granulosus being a rare cause. Most cases occur in transplant recipients, and breakthrough infections may develop after azole therapy due to cryptic species and antifungal resistance. Here, we present the first non-transplant case of breakthrough A. granulosus infection following azole therapy with a fatal outcome. This case highlights the importance of early diagnosis, accurate species identification, and appropriate antifungal treatment for breakthrough invasive fungal infections.MedicineImmunology and MicrobiologyArticleSCOPUS10.1016/j.mmcr.2026.1007822-s2.0-105032867490