Lomentospora prolificans fungemia in hematopoietic stem cell transplant patients: First report in South America and literature review

Abstract

Lomentospora prolificans is a filamentous fungus and an emerging pathogen in immunocompromised patients. It is encountered most commonly in Australia, Spain, and USA. We described the first case of Lomentospora prolificans fungemia in South America. The patient was a hematopoietic stem cell transplantation (HSCT) recipient who developed the infection 37 days after stem cells infusion. In addition, we performed a literature review of invasive lomentosporiosis in HSCT patients.

Emerging Fungal Infections: New Patients, New Patterns, and New Pathogens

“…From 2004 to 2007, Neofytos et al highlighted that up to 15% of invasive mould infections following transplant were non- Aspergillus [118]. Among HSCT recipients, 29 cases of invasive L. prolificans infection have been published and associated with over 80% mortality [119].…”

Non-Aspergillus Hyaline Molds: Emerging Causes of Sino-Pulmonary Fungal Infections and Other Invasive Mycoses

“…2 While Mucorales remain the predominant cause of breakthrough fungal infection in patients with hematologic malignancy, breakthrough infection due to Scedosporium species is documented in patients receiving posaconazole, voriconazole, isavuconazole, itraconazole, and lipid formulation amphotericin B for antifungal prophylaxis or treatment. [10][11][12][13][14] Among solid organ transplant (SOT) recipients, Scedosporium species and L. prolificans represent approximately 25% of non-Aspergillus mold infections. 6,15 The majority of infections occur in lung transplant recipients.…”

“…3,9 In contrast, disseminated disease and fungemia are observed in 70 to 80% and 33% of HSCT recipients, respectively. 9,12,13 Of note, fatal scedosporiosis due to donorderived infection is described in SOT recipients of donors who suffered near-drowning. 25,26 There are limited data evaluating outcomes among CF patients colonized with Scedosporium species and L. prolificans who subsequently undergo lung transplantation, and some transplant centers consider colonization with these organisms as a contraindication to transplant.…”

“…9,34 Higher mortality is observed with L. prolificans versus Scedosporium species infections. 9,12,34 In neutropenic patients who do not experience neutrophil recovery, mortality is 70 to 100%. 12,13 Fusarium Fusarium species are widely distributed in soil and plants and may cause superficial, locally invasive, or disseminated disease in humans depending on host immunity.…”

“…9,12,34 In neutropenic patients who do not experience neutrophil recovery, mortality is 70 to 100%. 12,13 Fusarium Fusarium species are widely distributed in soil and plants and may cause superficial, locally invasive, or disseminated disease in humans depending on host immunity. Worldwide there are at least 200 Fusarium species grouped into approximately ten phylogenetic species complexes.…”