Fatal Trichoderma harzianum infection in a leukemic pediatric patient

• 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
• ISSN: 1369-3786; 1460-2709
• DOI: 10.1080/13693780802406225

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.