Invasive pulmonary mycosis due to Chaetomium globosum with false‐positive galactomannan test: a case report and literature review

Abstract

In this case, the authors report Chaetomium globosum as a cause of invasive pulmonary infection in a patient with Wegener's granulomatosis. Fungal hyphae (KOH and Calcofluor) were seen on direct microscopy of lung biopsy sample and bronchoalveolar lavage (BAL) sample. C. globosum isolated on culture clinched the diagnosis of invasive pulmonary infection by Chaetomium spp. A positive galactomannan of serum and BAL was repeatedly seen and was utilised for follow-up and as prognostic marker in patient management. The patient was successfully treated with liposomal amphotericin B followed by voriconazole. All the Chaetomium infections reported till date since 1980 are reviewed. Chaetomium spp. with its unique ecology has a hidden clinical potential to cause invasive mould infections.

Canine systemic mycosis associated withChaetomium globosumin a dog

“…In a previous study, a dog with systemic aspergillosis with central nervous system involvement that was treated with combination voriconazole and terbinafine had good long‐term survival . As in our case, most invasive cases of C. globosum in humans (16/19) are fatal . Unfortunately, there is not enough scientific information to establish the most effective treatment of systemic mycosis associated with C. globosum in dogs.…”

“…C. globosum is a saprobic ascomycete found in natural environments worldwide. It is the third most frequent indoor fungal contaminant of wet buildings and it has been isolated from soil, animal dung, straw, foods, carpet, wallpaper and wet walls . Generally, it does not cause disease in humans, and infections are rarely reported.…”

“…Generally, it does not cause disease in humans, and infections are rarely reported. To date, only about 40 cases of mycosis associated with C. globosum have been described in the human literature . However, it has potential to cause deep disseminated infections (e.g.…”

“…However, it has potential to cause deep disseminated infections (e.g. invasive pulmonary mycosis), especially in immunocompromised patients, and is considered a causative agent for emerging fungal infections in humans . A human case of fatal cerebral mycosis has been previously reported in Australia .…”

“…Other manifestations of systemic disease produced by Chaetomium spp . in humans include pulmonary infections, sinusitis or non‐atopic asthma . To date, focal dermatological problems (depilation, scales and dermatitis with slightly itchiness on his skin) had been the only clinical manifestation associated with Chaetomium spp.…”