Invasive Trichoderma longibrachiatum breakthrough infection in a hematology patient

Area of Science:

• Mycology
• Infectious Diseases
• Clinical Case Study

Background:

• Trichoderma species are increasingly recognized as opportunistic pathogens.
• Invasive fungal infections pose a significant threat to immunocompromised individuals.

Observation:

• A 61-year-old neutropenic female with T-cell lymphoma developed a breakthrough infection.
• The patient had a probable invasive pulmonary aspergillosis and was receiving liposomal amphotericin B.

Findings:

• Infection with Trichoderma longibrachiatum and Aspergillus fumigatus was confirmed.
• The Trichoderma longibrachiatum isolate was resistant to isavuconazole but susceptible to amphotericin B, voriconazole, itraconazole, and olorofim.

Implications:

• This case underscores the potential pathogenicity of Trichoderma species.
• Antifungal susceptibility testing is crucial for guiding treatment of rare fungal infections.
• Further research is needed to understand Trichoderma pathogenesis and optimize treatment strategies.