Angioinvasive, cutaneous infection due to Colletotrichum siamense in a stem cell transplant recipient: Report and review of prior cases

Abstract

| INTRODUC TI ONColletotrichum species are filamentous fungi that infect a diversity of economically important crops worldwide, causing "anthracnose" disease, and are extensively studied as a model pathosystem in plant pathology. 1,2 This plant pathogen is increasingly recognized in human infections, with disease primarily related to inoculation of organic or woody material into ocular or cutaneous surfaces. 3,4 Keratitis and/or endophthalmitis are typical in non-immunocompromised patients, 4 while skin and soft tissue infections are rarely described and predominantly seen in immunocompromised patients. 5 Deeper infection beyond the immediately surrounding structures (eg, pneumonia) has been speculated, but not definitively proven. 6 Described treatment modalities include local debridement ± a triazole or amphotericin, though ideal therapy has not been established.Complicating matters of identification and treatment selection, the genus Colletotrichum has undertaken many taxonomic changes in the last two decades, with 14 currently accepted monophyletic clades (ie, "species complexes") encompassing >200 species. 7 Of these, primarily Colletotrichum gloeosporioides 3,5,8-12 and Colletotrichum coccodes, 6,13 as well as Colletotrichum crassipes, 14 Colletotrichum truncatum, 15 Colletotrichum graminicola, 16 and Colletotrichum dematium, 4 have been identified as causes of human infections. C gloeosporioides, however, is now considered a species complex comprised of multiple species including Colletotrichum siamense. 17We present here an unusual case of angioinvasive, extraocular Colletotrichum infection, identified as a novel isolate via contemporary phylogenetic analysis. | C A S E REP ORTThe patient was a 66-year-old woman with relapsed diffuse large B-cell lymphoma for which she underwent non-myeloablative peripheral blood stem cell transplant complicated by profound neutropenia. Her conditioning regimen included rituximab, ifosfamide, carboplatin, etoposide, and total body irradiation, in addition to cyclophosphamide and intravenous cefepime for transient Abstract Colletotrichum is an important fungal plant pathogen, yet an uncommon cause of human disease. Herein we report a case of invasive, cutaneous infection in a stem cell transplant recipient due to Colletotrichum species, with accompanying review of the literature. The infection was successfully treated with a combination of liposomal amphotericin B and voriconazole. Multilocus phylogenetic analysis revealed that the distinct isolate belongs to Colletotrichum siamense, a member of the Colletotrichum gloeosporioides species complex not previously described as a human pathogen.Colletotrichum infection remains in the differential for skin lesions in the immune compromised host.

Colletotrichum species pathogenic to strawberry: discovery history, global diversity, prevalence in China, and the host range of top two species

“…Notably, some Colletotrichum species pathogenic to strawberry even infect members of other kingdoms beyond plant hosts. For example, the prevalent C. siamense in strawberry fields had been reported as a human pathogen resulting in skin lesions in the immune compromised host (Werbel et al 2019). C. truncatum was reported as an opportunistic human pathogen (Valenzuela-Lopez et al 2018).…”

Colletotrichum Species Associated with Anthracnose in Salix babylonica in China

“…Colletotrichum pathogens often cause damage to roots, stems, leaves, flowers, fruits, and seedlings of trees, fruit trees, vegetables, flowers, medicinal plants, and field crops and can lead to plant wilting, anthracnose, fruit rot, leaf lesions, and other symptoms, causing serious economic losses [10,11]. Many species of Colletotrichum not only affect a wide range of host plants, but also have direct implications for human health [12][13][14]. Therefore, their accurate identification is critical because species differ in pathogenicity, fungicide sensitivity, and other factors affecting disease management in nurseries and seed orchards [15].…”