Fatal Trichoderma harzianum infection in a leukemic pediatric patient

We report the repeated isolation for Trichoderma.harzianum, a rare opportunistic pathogen from three sets of each of the following clinical samples; blood serum, skin lesions, sputum and throat of a pediatric ALL patient with neutropenia. The definition of invasive fungal infection requires evidence...

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Bibliographic Details
Published in:Medical mycology (Oxford) 2009-01, Vol.47 (2), p.207-215
Main Authors: Kantarcio lu, A. Serda, Celkan, Tiraje, Yücel, Ayhan, Mikami, Yuzuru, Kurugoglu, Sebuh, Mitani, Hiroki, Altas, Kemal
Format: Article
Language:English
Subjects:
Antifungal Agents - pharmacology
Antifungal Agents - therapeutic use
Child
Drug Resistance, Fungal
Fatal Outcome
Humans
Latex Fixation Tests
Male
Microbial Sensitivity Tests
Mycoses - diagnosis
Mycoses - microbiology
Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications
Trichoderma - classification
Trichoderma - drug effects
Trichoderma - genetics
Trichoderma - isolation & purification
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Summary:We report the repeated isolation for Trichoderma.harzianum, a rare opportunistic pathogen from three sets of each of the following clinical samples; blood serum, skin lesions, sputum and throat of a pediatric ALL patient with neutropenia. The definition of invasive fungal infection requires evidence of the presence of fungal elements in tissue samples, in addition to the isolation of suspected etiologic agent in culture. However, invasive procedures are not always applicable due to several factors, as for example in our case, the poor general status of the individual patient or thrombocytopenia. The present paper also emphasizes the problems encountered in obtaining appropriate samples and diagnosing invasive fungal disease in immunocompromised patient populations, including those with hematological malignancy. Three cases involving T. harzianum, including this one, have been described thus far in the literature. All were fatal and the fungus was resistant to antifungal therapy. A critical review of the other two cases of Trichoderma infections in humans is provided.
ISSN:1369-3786
1460-2709
DOI:10.1080/13693780802406225