Subcutaneous hyalohyphomycosis caused by Fusarium in a kidney transplant recipient

Area of Science:

• Mycology
• Transplant Infectious Diseases

Background:

• Fusarium species are opportunistic pathogens causing superficial and invasive infections, particularly in immunocompromised individuals.
• Disseminated Fusarium infections are life-threatening, while localized infections in solid organ transplant recipients are rare and typically have a better prognosis.

Observation:

• A rare case of subcutaneous, non-invasive Fusarium infection is described in a renal allograft recipient 2.5 years post-transplant.
• The patient had a history of cytomegalovirus (CMV) infection and recurrent co-infections, contributing to their immunocompromised state.

Findings:

• Diagnosis was confirmed by culturing Fusarium species from tissue specimens.
• The infection showed a protracted course, with lesions persisting after initial treatment with voriconazole alone.

Implications:

• Treatment necessitated a combination of complete surgical excision and antifungal therapy for resolution.
• This case highlights the importance of considering Fusarium infections in solid organ transplant recipients, even with non-invasive presentations, and the potential need for multimodal treatment strategies.