Hormographiella aspergillata: an emerging basidiomycete in the clinical setting? A case report and literature review

Abstract

Background Filamentous basidiomycetes are mainly considered to be respiratory tract colonizers but the clinical significance of their isolation in a specimen is debatable. Hormographiella aspergillata was first reported as a human pathogen in 1971. We discuss the role of this mold as a pathogen or colonizer and give an update on diagnostic tools and in vitro antifungal susceptibility. Case presentation We identified three cases of H. aspergillata with respiratory symptoms in a short period of time. One invasive infection and two colonizations were diagnosed. Culture supernatants showed that H. aspergillata can produce galactomannan and β-D-glucan but not glucuronoxylomannan. For the first time, isavuconazole susceptibility was determined and high minimum inhibitory concentrations (MICs) were found. Liposomal amphotericin B and voriconazole have the lowest MICs. Conclusion To date, 22 invasive infections involving H. aspergillata have been reported. On isolation of H. aspergillata, its pathogenic potential in clinical settings can be tricky. Molecular identification and antifungal susceptibility testing are essential considering high resistance against several antifungal therapies.

Successful Treatment of Rare Pulmonary Coprinopsis cinerea Infection in a 17-Year-Old Female After Hematopoietic Stem Cell Transplantation: A Case Report

“… 19 In addition, strains of C. cinerea resistant to various antifungal agents, including azoles, echinocandins, and amphotericin B, have been reported in different institutions. 9 , 13 , 22 , 23 Echinocandins, such as caspofungin and micafungin, may not be recommended as a treatment options, probably because of the high MICs in many of the reported cases. 10 , 14 , 24 , 25 Fluconazole, flucytosine, and itraconazole have also been reported to have high MICs.…”

Necrotizing scleritis due to Hormographiella aspergillata

“…However, amphotericin B (MIC: 0.094-4 mg/mL) and voriconazole (0.015-8 mg/mL) seem to be the antifungals of choice. 4 Fungal scleritis is most commonly caused by Aspergillus spp., but many other species have been cultured, mainly filamentous fungi. Ocular involvement has been described in two patients with severe keratitis and endophthalmitis following cataract surgery, which ultimately required evisceration.…”

“…It rarely acts as a pathogen, although pulmonary, cardiac, cutaneous and disseminated infections have been reported, mainly in immunocompromised hosts. 4 Due to the limited number of documented cases there are currently no guidelines on the interpretation of MIC of antifungals for H. aspergillata . However, amphotericin B (MIC: 0.094–4 mg/mL) and voriconazole (0.015–8 mg/mL) seem to be the antifungals of choice.…”

Invasive Hormographiella aspergillata infection in patients with acute myeloid leukemia: Report of two cases successfully treated and review of the literature

“…H. aspergillata has been described as a rare cause of fungal infection in humans. Cases of prosthetic valve endocarditis and intraocular lens-implant-associated endophtalmitis have been described in immunocompetent patients [ 2 , 3 ], but the most severe cases have been reported as lung and disseminated infections in immunocompromised hosts, in particular those with hematological malignancies [ [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] ]. The elevated mortality rate (around 80%) may result from delayed diagnosis and therapy, in the absence of detection by common fungal biomarkers (e.g.…”