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Mycetoma Caused by Acremonium Species in a Patient with Chronic Granulomatous Disease

Richard Antrobus1, Gabriel Wong1, Julie Jones1

  • 1Department of Immunology, Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK.

Case Reports in Immunology
|March 30, 2016
PubMed

Insights

Patients with chronic granulomatous disease (CGD) on antifungal prophylaxis can still develop fungal infections. This case shows Acremonium causing a mycetoma despite treatment, emphasizing vigilant monitoring for immunodeficient patients.

Area of Science:

  • Mycology
  • Immunology
  • Dermatology

Background:

  • Chronic granulomatous disease (CGD) patients have impaired neutrophil function, increasing susceptibility to infections.
  • Antifungal prophylaxis is standard care for CGD patients to prevent invasive fungal infections.
  • Fungal mycetoma is a chronic subcutaneous infection often caused by soil-dwelling fungi.

Purpose of the Study:

  • To report a case of Acremonium-induced cutaneous mycetoma in a CGD patient receiving antifungal prophylaxis.
  • To highlight the challenges in managing fungal infections in immunocompromised individuals.
  • To emphasize the importance of clinical vigilance and diagnostic workup in CGD patients.

Main Methods:

  • Case report detailing a patient with CGD.
  • Clinical presentation and microbiological identification of Acremonium species.
  • Treatment course with voriconazole and patient follow-up.

Main Results:

  • A CGD patient developed a cutaneous mycetoma caused by Acremonium.
  • The infection occurred despite the patient receiving standard antifungal prophylaxis.
  • Treatment with voriconazole led to gradual resolution of the mycetoma.

Conclusions:

  • Fungal infections can occur in CGD patients even with antifungal prophylaxis.
  • Acremonium is a potential pathogen causing mycetoma in immunocompromised hosts.
  • Close clinical monitoring and prompt investigation are crucial for managing infections in neutrophil immunodeficiency.

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