First Report of an Invasive Infection by Cephalotrichum gorgonifer in a Neutropenic Patient with Hematological Malignancy under Chemotherapy.

Ana Álvarez-Uría,Pilar Escribano,Gillen Oarbeascoa,Jesús Guinea,José Francisco Cano-Lira,Verónica Parra-Blanco,Alberto Miguel Stchigel,Patricia Muñoz

doi:10.3390/jof7121089

Abstract

The etiological agents of infrequent invasive fungal infections (IFI) are difficult to identify on the species level using classic morphological examination. We describe the first case of an IFI caused by Cephalotrichum gorgonifer in a neutropenic patient with a hematological malignancy and put it on the map as a new causative agent of IFI. Case report, microbiological findings and description of the etiological agent. A 60-year-old man was diagnosed with mantle cell lymphoma. A CT scan confirmed the presence of lung infiltrates located at the right upper lobe. Histological examination of one of the nodules showed a large number of narrow septate hyphae with acute-angle branching and irregular round cell morphology; vessels walls appeared infiltrated, proving an angioinvasive pulmonary IFI. Sample culture resulted positive and molecular identification proved the presence of Cephalotrichum gorgonifer. Voriconazole was used for 12 months and the patient did not report any complications or side effects. Complete remission of lymphoma was achieved later by the time chemotherapy, radiotherapy, and radioimmunotherapy consolidation were completed. We recommend the inclusion of Cephalotrichum gorgonifer in the list of opportunistic pathogens causing mycoses in neutropenic hematological patients with suspected mould-related IFI.

Highlights

Changes in epidemiology and in antifungal prophylaxis strategies are leading to an increasing number of other emerging opportunistic moulds causing IFIs [2,3]
The etiological agents of infrequent IFIs are difficult to identify on the species level using classic morphological examination; molecular techniques may be helpful for the identification of such fungal pathogens [3,4]
The colonies on potato dextrose agar (PDA; Pronadisa, Madrid, Spain) at 25 °C achieved a diameter of 72–78 mm after 14 days of incubation; initially, they were hyaline, velvety to slightly cottony, becoming grey and fasciculate with age, in the center part in their upper surface, and grey on reverse region formed a more or less cylindrical sporulating head of 300–700 μm long; numerous rhizoids, septate, brown, mostly unbranched, 200–950 μm long, were present; sterile setae formed at the upper part of the synnemata septates, which were branched, smooth-/thinwalled, pale brown, coiled, up to 500 μm long and 3–4 μm wide

Summary

Introduction

The etiological agents of infrequent IFIs are difficult to identify on the species level using classic morphological examination; molecular techniques may be helpful for the identification of such fungal pathogens [3,4]. J. Fungi 2021, 7, 1089 morphological examination; molecular techniques may be helpful for the. We describe the first case of an IFI caused by Cephalotrichum gorgonifer (Bainier). We describe the firstincase of an IFI caused by Cephalotrichum gorgonifer malignancy (Bainier) and put it on the map as a new causative agent of IFIs. Sand.-Den., Gené & Guarro, in a neutropenic patient with a hematological malignancy and put it on the map as a new causative agent of IFIs

Case Presentation

Cephalotrichum

Typical

Discussion