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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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Non-Candida fungal cholecystitis - an uncommon occurrence even in the right host

Mitchell G Dumais1, Mary M Czech2, Mustafa A Hyder3

  • 1Intramural Clinical Management Operations Branch, Office of the Clinical Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA. Mitchell.Dumais@nih.gov.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|May 13, 2026
PubMed

Insights

Invasive fungal infections, like Lomentospora prolificans, can cause acute cholecystitis in transplant patients. A novel antifungal, fosmanogepix, combined with surgery, successfully treated a rare case.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Hematology

Background:

  • Invasive fungal infections (IFI) are a major cause of death in patients with blood cancers and after stem cell transplants.
  • Mold cholecystitis is an extremely rare complication of IFIs.

Purpose of the Study:

  • To describe a rare case of disseminated Lomentospora prolificans infection presenting as acute cholecystitis in a patient post-hematopoietic cell transplant (HCT).
  • To review existing literature on non-Candida fungal cholecystitis, including risk factors and treatment strategies.

Main Methods:

  • Case report of a patient with hematologic malignancy and HCT recipient.
  • Treatment involved temporary cholecystostomy, novel antifungal agent fosmanogepix, cholecystectomy, and completion of antifungal therapy.
  • Literature review of non-Candida fungal cholecystitis.

Main Results:

  • The patient experienced a recrudescence of Lomentospora prolificans infection with acute cholecystitis.
  • Successful treatment with fosmanogepix and surgical intervention (cholecystostomy and cholecystectomy) led to infection resolution.
  • Literature review identified risk factors and treatment options for fungal cholecystitis.

Conclusions:

  • Disseminated Lomentospora prolificans can manifest as acute cholecystitis in immunocompromised patients.
  • Fosmanogepix represents a promising therapeutic option for rare invasive fungal infections.
  • Prompt diagnosis and multimodal treatment are crucial for managing fungal cholecystitis in HCT recipients.
Keywords:
Disseminated Lomentospora prolificansHematopoietic cell transplant (HCT)ImmunosuppressionInvasive fungal infection (IFI)Mold cholecystitis

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