Trichoderma pseudokoningii as a Cause of Fatal Infection in a Bone Marrow Transplant Recipient

Gautheret, A.; Dromer, Françoise; Bourhis, Jean‐Henri; Andremont, Antoine

doi:10.1093/clinids/20.4.1063

Cited by 52 publications

(35 citation statements)

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“…It has become apparent that most reports of infection implicate the thermotolerant species T. longibrachiatum, as determined through a better understanding of species concepts and by molecular reevaluation of published case isolates (3,7,14,25). Furukawa et al (6) described acute invasive sinusitis secondary to T. longibrachiatum in an immunocompromised patient, and Kuhls et al (14) briefly mentioned a case of maxillary sinus infection.…”

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confidence: 99%

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Allergic Fungal Sinusitis Associated with Trichoderma longibrachiatum

et al. 2003

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We describe allergic fungal sinusitis caused by Trichoderma longibrachiatum in a patient with a history of atopy and asthma. A Gram stain of a sinus biopsy specimen was initially thought to contain yeast cells, but when Trichoderma was recovered in culture, these cells were subsequently recognized as chlamydospores. The patient was successfully managed with a combination of sinus lavage, oral corticosteroids, itraconazole, and allergen immunotherapy. This case also points out that careful scrutiny of direct smears is required to ensure that fungal structures are not misinterpreted.

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confidence: 99%

“…longibrachiatum is an uncommon cause of invasive, sometimes fatal infection in immunocompromised patients (3,32). Sites involved include brain (7,21,24,29), skin (21), and peritoneum (33). A recent case of otitis externa in an otherwise healthy 12-year-old boy was resolved following treatment with topical nystatin (10).…”

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Allergic Fungal Sinusitis Associated with Trichoderma longibrachiatum

et al. 2003

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“…Systematic echocardiographic study during the course of pulmonary IA could allow better Aspergillus antigen has never been reported in cases of human infections caused by other filamentous fungi, except in one estimation of the prevalence of this complication and probably facilitate improved care of patients because of earlier diagnosis. recently reported case of disseminated Trichoderma pseudokoningii infection [46]. False positivity due to airborne contamWhen clinical, radiological, electrocardiographic, or echocardiographic symptoms of pericardial involvement were presination in the laboratory [47] was unlikely in our case because antigen was persistently detected by use of the two methods ent, the appearance of tamponade usually followed quickly, as in our patient.…”

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Aspergillus Pericarditis with Tamponade: Report of a Successfully Treated Case and Review

et al. 1998

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and Philippe CasassusWe report a case of aspergillus pericarditis with tamponade complicating invasive pulmonary aspergillosis in a patient treated for acute lymphocytic leukemia. Prolonged antifungal therapy and aggressive surgical treatment cured the pericarditis, without relapse, despite the fact that the patient underwent autologous bone marrow transplantation. In a review of 28 other cases of aspergillus pericarditis, we found that this condition usually had occurred in severely immunocompromised patients and was always the result of contiguous dissemination of Aspergillus from the lung or myocardium. Tamponade was present in eight of 29 patients. Aspergillus antigen was detected in the pericardial fluid of all three patients whose fluid specimens were tested. Aspergillus pericarditis was diagnosed before death in 10 of 29 patients, all of whom had established premortem diagnoses of invasive aspergillosis at other sites and had received antifungal therapy. Three of the four survivors received combined medical and aggressive surgical therapies. The performance of echocardiography early during the course of invasive pulmonary aspergillosis, together with intensive combined therapies, might lower the high mortality associated with aspergillus pericarditis.Invasive aspergillosis (IA) has become a common fungal pergillus and aspergillosis with the terms pericarditis, pericardium, hemopericardium, myocarditis, and pancarditis. We also infection in patients who have profound neutropenia for prolonged periods. The prevalence of IA is estimated to be as high reviewed the published series and reviews on infectious pericarditis and IA in patients with AIDS, chronic granulomatous as 70% among patients who have been granulocytopenic for 1 month [1]. IA is also being observed increasingly in patients disease (CGD), leukemia, lymphoma, and solid organ and bone marrow transplants and in those receiving corticosteroid therwith solid organ transplants, late-stage AIDS, and diabetes mellitus and in those who have received prolonged corticosteroid apy. References cited in the articles reviewed were also scrutinized for potential additional cases. therapy. The most frequent sites of IA are the lungs and nasal sinuses, but dissemination occurs in 20% -30% of immuno-A case could be evaluated when sufficient demographic information was available for the clear identification of an indicompromised patients [2]. Cardiac involvement is uncommon and most often manifests as endocarditis or myocarditis [2]. vidual patient. We considered aspergillus pericarditis to be present in patients who had (1) evidence of clinical and/or Pericardial aspergillosis is rarely diagnosed before death and has been considered always fatal in neutropenic patients [3]. macroscopic involvement of the pericardium during the course of histologically and mycologically confirmed IA, without any We report a case of pericardial aspergillosis with tamponade in which combined antifungal and surgical therapies were sucreported alternative cause of pericarditis; (2) a ...

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“…Several clinical Sequencing experiments of the ITS-region confirmed the identifications made on the basis of PCR-fingerprinting data. The results of this study revealed that it is necessary to reidentify a morphologically identified clinical T. pseudokoningii strain [18] as T. longibrachiatum. …”

Section: Systematic Studies On Clinical Trichoderma Isolatesmentioning

confidence: 94%

“…The fungus was isolated from specimens obtained by bronchoalveolar lavage and skin biopsy. Autopsy has shown that the infection was disseminated: hyphae were present in the lungs, brain, heart, stomach and pretracheal abscesses [18]. A fatal disseminated T. longibrachiatum infection occured in a patient who had received an allogenic bone marrow transplant for acute lymphoblastic leukemia.…”

Section: The Number Of Cases Of Trichoderma Infection In Immunocompromentioning

confidence: 99%