Disseminated fungal infection by Aureobasidium pullulans in a renal transplant recipient

Area of Science:

• Mycology
• Immunocompromised Host Infections
• Transplant Infectious Diseases

Background:

• Renal transplant recipients require long-term immunosuppression, increasing susceptibility to opportunistic infections.
• Dematiaceous fungi, like Aureobasidium pullulans, are emerging as significant pathogens in immunocompromised individuals.
• Aureobasidium pullulans, a black yeast, typically causes localized infections via inoculation but rarely disseminated disease.

Observation:

• A pediatric patient who received a renal transplant developed a disseminated fungal infection.
• The infection was caused by Aureobasidium pullulans, a dematiaceous fungus.
• Disseminated mycoses are exceptionally rare in transplant patients, especially from this specific fungus.

Findings:

• The case highlights a rare instance of disseminated Aureobasidium pullulans infection in a pediatric renal transplant recipient.
• Successful management involved a combination of antifungal therapy (voriconazole) and surgical intervention (vacuum-assisted closure and drainage).

Implications:

• This case underscores the importance of considering rare fungal pathogens in immunocompromised patients.
• Prompt and multimodal treatment strategies can be effective in managing severe opportunistic mycoses.
• Further research into the pathogenesis and treatment of Aureobasidium pullulans in transplant recipients is warranted.