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

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 spp.-related pneumonia (TRP) after heart-lung transplantation. I...

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Bibliographic Details
Published in:Journal of fungi (Basel) 2023-02, Vol.9 (2), p.195
Main Authors: Burzio, Carlo, Balzani, Eleonora, Montrucchio, Giorgia, Trompeo, Anna Chiara, Corcione, Silvia, Brazzi, Luca
Format: Article
Language:English
Subjects:
Amphotericin B
Bias
cardiac surgery
Case reports
Caspofungin
critical care
Data collection
Disease prevention
emerging fungal infections
Epidemiology
Fungal infections
Grey literature
Heart
Heart transplantation
heart–lung transplantation
Literature reviews
Lung transplantation
Lung transplants
Nosocomial infection
Nosocomial infections
Patients
Pneumonia
Sepsis
Systematic Review
Trichoderma
Trichoderma spp
Voriconazole
Weaning
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Summary: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 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 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 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.
ISSN:2309-608X
2309-608X
DOI:10.3390/jof9020195