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Invasive Chrysosporium infection of the nose and paranasal sinuses in an immunocompromised host
F E Levy1, J T Larson, E George
1Department of Otolaryngology, University of Minnesota Medical Center, Minneapolis 55455.
Abstract:
Aggressive fungal rhinosinusitis with Chrysosporium sp. occurred in a patient with acute lymphocytic leukemia. The infecting organism is an exceedingly rare human pathogen. Usually, human chrysosporial infections are mild and unmarked by symptoms. Most case reports appear in the pathology literature and describe the incidental finding of adiaspores in the pulmonary parenchyma at autopsy. Clinical disease from active growth of chrysosporial mycelia in human tissues has been noted on a porcine aortic valve prosthesis and in a tibial abscess. Hyphal elements were not recovered from any other body parts of these patients. Histopathologic and microbiologic studies permitted the identification of this rarely encountered organism. Our patient experienced systemic spread of Chrysosporium organisms. Treatment of this pathogen is the same as for other opportunistic fungal infections.
Insights
A rare Chrysosporium fungal infection caused aggressive rhinosinusitis in an acute lymphocytic leukemia patient. This case highlights systemic spread of this usually mild pathogen, requiring opportunistic infection treatment.
Area of Science:
- Mycology
- Infectious Diseases
- Hematology
Background:
- Chrysosporium species are rare human pathogens, typically causing mild, asymptomatic infections.
- Most reported cases involve incidental findings of fungal elements in pulmonary parenchyma at autopsy.
- Previous clinical disease manifestations include infections on prosthetic valves and in abscesses.
Observation:
- A patient with acute lymphocytic leukemia developed aggressive fungal rhinosinusitis.
- The infection was caused by Chrysosporium sp., an uncommon agent of human disease.
- Histopathologic and microbiologic studies confirmed the identification of the organism.
Findings:
- The patient experienced systemic spread of Chrysosporium organisms.
- Unlike typical presentations, the fungal infection was aggressive and symptomatic.
- Hyphal elements were found beyond the initial site of infection.
Implications:
- This case underscores the potential for Chrysosporium to cause severe, invasive disease in immunocompromised individuals.
- Early identification and treatment are crucial for managing disseminated fungal infections.
- Treatment protocols for opportunistic fungal infections are applicable to Chrysosporium.