Palatal perforation caused by Alternaria alternata infection in an immunocompetent adolescent

•Invasive fungal infections are on the rise among immunocompromised populations.•Using whole-genome sequencing, we identified a novel etiology of palatal perforation.•This novel pathomycete of palatal perforation was found in an immunocompetent adolescent.•Multidisciplinary treatment helps the promp...

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Bibliographic Details
Published in:International journal of infectious diseases 2023-09, Vol.134, p.207-210
Main Authors: Chen, Junjun, Yao, Hui, Yuan, Xiaoling, Yan, Lei, Tang, Guoyao, Yan, Kepeng, Shen, Xuemin
Format: Article
Language:English
Subjects:
Adolescent
Alternaria
Alternaria alternata
Biopsy
Humans
Immunocompetent individuals
Invasive fungal infections
Male
Mycoses - diagnosis
Mycoses - drug therapy
Opportunistic Infections
Oral infection
Palatal perforation
Voriconazole - therapeutic use
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Summary:•Invasive fungal infections are on the rise among immunocompromised populations.•Using whole-genome sequencing, we identified a novel etiology of palatal perforation.•This novel pathomycete of palatal perforation was found in an immunocompetent adolescent.•Multidisciplinary treatment helps the prompt diagnosis and specific treatment of invasive fungal infections. Opportunistic oral mucosal fungal infection caused by Alternaria alternata is extremely rare. Herein, we present a rare palatal perforation as a result of oral infection caused by A. alternata in an immunocompetent adolescent. An 18-year-old boy, who had previously been healthy, was admitted to our institution with persistent pain in the palate for the past 12 months. Upon impression of palatal bone resorption based on computed tomography imaging and chronic granulomatous inflammation based on biopsy (hematoxylin-eosin staining), the patient was examined for commonly relevant causes such as potential tumor and Mycobacterium tuberculosis infection. All test results were inconclusive. After a thorough diagnostic investigation, an unusual fungal infection, A. alternata infection, was confirmed by next-generation sequencing and biopsy (periodic acid-Schiff staining and immunofluorescence staining). The patient underwent surgical debridement and was subjected to voriconazole treatment postoperatively for over a period of 5 months. Thus, these findings highlight the importance of considering A. alternata as a potential pathogenic factor in an etiological palatal perforation.
ISSN:1201-9712
1878-3511
DOI:10.1016/j.ijid.2023.06.019