Unsuspected embolic fungal endocarditis of an aortic conduit diagnosed by transesophageal echocardiography

Bustamante-Labarta, Miguel H.; Caramutti, Victor; Allende, Gustavo N.; Weinschelbaum, Ernesto E.; Torino, Augusto

doi:10.1067/mje.2000.106726

Cited by 12 publications

(6 citation statements)

References 6 publications

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“…Clinical manifestations may greatly vary and include pulmonary mycetoma, ulceronecrotic skin lesions, brain or liver abscess, endocarditis, sinusitis, necrotizing stomatitis, and dialysis‐related peritonitis. Trichoderma longibrachiatum , the main human pathogen within the genus, has been isolated in 18 of the total 37 patients described in the literature . Of note, invasive infections caused by this pathogen have more frequently been reported in patients with hematological or solid organ malignancies on immunosuppressive therapies and in patients on ambulatory peritoneal dialysis .…”

Section: Discussionmentioning

confidence: 99%

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Trichoderma species fungemia after high‐dose chemotherapy and autologous stem cell transplantation: a case report

Festuccia

Giaccone

Brunello

et al. 2014

Transplant Infectious Dis

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Section: Discussionmentioning

confidence: 99%

“…Few cases have been reported and included localized as well as disseminated infections, with mortality rates as high as 50%. Principal sources of contamination were ambient air, water‐related sites, food, and venous catheters .…”

mentioning

confidence: 99%

Trichoderma species fungemia after high‐dose chemotherapy and autologous stem cell transplantation: a case report

Festuccia

Giaccone

Brunello

et al. 2014

Transplant Infectious Dis

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“…They cause severe and persistent disseminated infections that usually fail to respond to treatment with amphotericin B (AMB) or voriconazole (VRC) (5)(6)(7)(8)(9). Other diseases attributed to members of this genus are allergic and acute invasive sinusitis (10,11), keratitis (12), otitis externa (13), skin and subcutaneous infections (14), peritonitis (9,(15)(16)(17)(18)(19)(20), deep pulmonary infections (21)(22)(23), endocarditis (24), and brain abscess (25). Most infections are caused by Trichoderma longibrachiatum, which is recognized as the main human pathogen of the genus (4,11,26), but eight other species (i.e., T. atroviride, T. citrinoviride, T. harzianum, T. koningii, T. orientale, T. pseudokoningii, T. reesei, and T. viride) have also been reported occasionally (4,(26)(27)(28).…”

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confidence: 99%

Phylogeny of the Clinically Relevant Species of the Emerging Fungus Trichoderma and Their Antifungal Susceptibilities

et al. 2014

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A set of 73 isolates of the emerging fungus Trichoderma isolated from human and animal clinical specimens were characterized morphologically and molecularly using a multilocus sequence analysis that included the internal transcribed spacer (ITS) regions of the nuclear ribosomal DNA and fragments of the translation elongation factor 1 alpha (Tef1), endochitinase CHI18-5 (Chi18-5), and actin 1 (Act1) genes. The most frequent species was Trichoderma longibrachiatum (26%), followed by Trichoderma citrinoviride (18%), the Hypocrea lixii/Trichoderma harzianum species complex (15%), the newly described species Trichoderma bissettii (12%), and Trichoderma orientale (11%). The most common anatomical sites of isolation in human clinical specimens were the respiratory tract (40%), followed by deep tissue (30%) and superficial tissues (26%), while all the animal-associated isolates were obtained from superficial tissue samples. Susceptibilities of the isolates to eight antifungal drugs in vitro showed mostly high MICs, except for voriconazole and the echinocandins.

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“…The reported cases of endocarditis are relatively recent, ranging from 2000 to 2016, representing 6.8% of cases, with 100% mortality. Of these, one patient was receiving home parenteral nutrition [ 45 ], one was a patient undergoing aortic surgery [ 34 ], and one was a patient undergoing ICD implantation complicated by pneumothorax [ 48 ].…”

Section: Resultsmentioning

confidence: 99%

Trichoderma spp.-Related Pneumonia: A Case Report in Heart–Lung Transplantation Recipient and a Systematic Literature Review

Burzio

Balzani

Montrucchio

et al. 2023

JoF

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Opportunistic and hospital-acquired infections are common among recipients of solid organ transplantation. New pathogens are increasingly reported in the intensive care unit (ICU) population. We report a case of a patient who developed Trichoderma spp.-related pneumonia (TRP) after heart–lung transplantation. In the absence of antifungal susceptibility testing, TRP was confirmed by histological examination, and empirical therapy with voriconazole and caspofungin was swiftly initiated. Complete resolution of pneumonia was obtained after prolonged combination therapy. Given the lack of guidelines, we conducted a systematic review to elucidate the diagnostic and therapeutic strategies to apply during Trichoderma infection. After deduplication and selection of full texts, we found 42 articles eligible for the systematic review. Pneumonia seems to be the most common clinical manifestation (31.8%). The most used antifungal therapy was amphotericin B, while combination therapy was also reported (27.3%). All the patients were immunocompromised except for one case. Despite the rarity of Trichoderma spp. infection, the increase in invasive fungal infections is of growing importance in ICU, considering their impact on mortality and the emergence of antifungal resistance. In the absence of prospective and multicenter studies, a review can provide useful insight regarding the epidemiology, clinical manifestations, and management of these unexpected challenges.

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Unsuspected embolic fungal endocarditis of an aortic conduit diagnosed by transesophageal echocardiography

Cited by 12 publications

References 6 publications

Trichoderma species fungemia after high‐dose chemotherapy and autologous stem cell transplantation: a case report

Trichoderma species fungemia after high‐dose chemotherapy and autologous stem cell transplantation: a case report

Phylogeny of the Clinically Relevant Species of the Emerging Fungus Trichoderma and Their Antifungal Susceptibilities

Trichoderma spp.-Related Pneumonia: A Case Report in Heart–Lung Transplantation Recipient and a Systematic Literature Review

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