Cutaneous Emboli of Invasive Basidiomycosis in a Child With Aplastic Anemia

Area of Science:

• Mycology
• Infectious Diseases
• Hematology

Background:

• Invasive fungal diseases (IFDs) pose a significant threat to immunocompromised individuals, contributing to high mortality rates.
• Severe aplastic anemia (SAA) is a condition characterized by bone marrow failure, leading to profound immunosuppression.
• Basidiomycetes are a fungal class rarely implicated in human infections, making their pathogenic potential a critical area of study.

Observation:

• A pediatric patient with SAA presented with acute onset of disseminated purpuric skin lesions.
• Skin biopsy revealed septated fungal hyphae within dermal blood vessels, indicative of angioinvasion.
• Molecular sequencing identified Earliella scabrosa as the causative agent of the disseminated infection.

Findings:

• Earliella scabrosa, a Basidiomycete, caused a fatal disseminated fungal infection in an immunocompromised child.
• Histopathology was crucial for the early diagnosis of invasive fungal elements in skin lesions.
• The infection proved refractory to systemic antifungal therapy, underscoring treatment challenges.

Implications:

• This case highlights the emerging threat of rare fungal pathogens like Earliella scabrosa in immunocompromised hosts.
• Early diagnosis through histopathology is vital for managing invasive fungal infections.
• Further research into the pathogenicity and treatment of Basidiomycete infections is warranted.