Acute Invasive Sinusitis Due toTrichoderma longibrachiatumin a Liver and Small Bowel Transplant Recipient

Abstract

We describe a case of acute invasive sinusitis due to an unusual moniliaceous fungus, Trichoderma longibrachiatum Rifai 1969 (a member of the class Hyphomycetes), in a small bowel and liver transplant recipient treated with tacrolimus (FK-506) and prednisone. The patient was successfully treated with surgical debridements and amphotericin B followed by oral itraconazole.

Allergic Fungal Sinusitis Associated with Trichoderma longibrachiatum

“…It has become apparent that most reports of infection implicate the thermotolerant species T. longibrachiatum, as determined through a better understanding of species concepts and by molecular reevaluation of published case isolates (3,7,14,25). Furukawa et al (6) described acute invasive sinusitis secondary to T. longibrachiatum in an immunocompromised patient, and Kuhls et al (14) briefly mentioned a case of maxillary sinus infection. We have described here a case of colonization of the paranasal sinuses by T. longibrachiatum in a patient with AFS.…”

“…A recent case of otitis externa in an otherwise healthy 12-year-old boy was resolved following treatment with topical nystatin (10). Acute invasive sinusitis secondary to T. longibrachiatum was reported in a patient who received a liver and small-bowel transplant (6). In that case, the infection was successfully treated with surgical debridement followed by administration of amphotericin B and oral itraconazole.…”

“…In that case, the infection was successfully treated with surgical debridement followed by administration of amphotericin B and oral itraconazole. Previous reports on T. longibrachiatum infections have documented in vitro resistance to various antifungals including itraconazole and amphotericin B (6,21,24,29). The relationship between in vitro MIC for various antifungals and in vivo response has not been established for Trichoderma species.…”

Clinical importance of the genusTrichoderma

“…The fungus was found to be persistent in the immunocompromised host despite amphotericin B treatment and surgical removal of the infected haematoma, however, the patient died of unrelated complications [20]. The acute invasive sinusitis caused by T. longibrachiatum in a liver and small bowel transplant recipient was succesfully treated with surgical debridements and amphotericin B followed by oral itraconazole [21]. Guarro et al…”

The fish egg microbiome : diversity and activity against the oomycete pathogen Saprolegnia

“…Even though Trichoderma species are commonly considered beneficial fungi, some Trichoderma strains, including T. harzianum, Trichoderma koningii, Trichoderma longibrachiatum, Trichoderma pseudokoningii and Trichoderma viride, maybe pathogenic to human (Escudero Gil et al, 1976;Loeppky et al, 1983;Jacobs et al, 1992;Gautheret et al, 1995;Seguin et al, 1995;Tanis et al, 1995;Campos-Herrero et al, 1996;Guiserix et al, 1996;Munoz et al, 1997;Furukawa et al, 1998;Guarro et al, 1999;Richter et al, 1999;Rota et al, 2000;Chouaki et al, 2002;Myoken et al, 2002;De Miguel et al, 2005). Some marine Trichoderma were associated to contaminated mussels and some were even toxic to aquatic animals, such as Artemia larvae (Sallenave-Namont et al, 2000;Marrouchi et al, 2013).…”