Acremonium mycetoma in a heart transplant recipient

Mycetomas are chronic, progressive infections caused either by fungi (eumycetoma) or filamentous bacteria (actinomycetoma) and are characterized by the triad of draining sinuses, tumefaction, and the presence of macroscopic grains. We describe a case of eumycetoma in a cardiac transplant recipient caused by the soil saprophyte Acremonium species. This represents only the fifth case of eumycetoma reported in a solid organ transplant recipient. With the population of immunosuppressed patients and the incidence of invasive fungal infections increasing, consideration should be given to unusual saprophytic fungal infections as emerging opportunistic pathogens.