Isolated pulmonary fusariosis caused by Neocosmospora pseudensiformis in a liver transplant recipient: A case report and review of the literature

Transpl Infect Dis. 2020 Dec;22(6):e13344. doi: 10.1111/tid.13344. Epub 2020 Jun 16.

Abstract

Neocosmospora pseudensiformis (formerly Fusarium pseudensiforme) is a hyaline mold in the Fusarium solani species complex that has been changed to the genus Neocosmospora. Invasive fusariosis is a rare fungal infection in solid organ transplantation. The most commonly reported manifestation of invasive fusariosis in this setting is localized cutaneous fusariosis. Here, we present the first case report of isolated N pseudensiformis pulmonary infection in a patient with non-alcoholic steatohepatitis cirrhosis who underwent orthotopic liver transplantation. A 67-year-old Thai woman developed acute graft rejection, dyspnea, and pulmonary consolidation 6 months after liver transplantation. N pseudensiformis was isolated from her sputum, and her clinical symptoms were improved with voriconazole treatment. However, she succumbed to Acinetobacter baumannii hospital-acquired pneumonia and acute coronary syndrome with cardiogenic shock after 10 days of treatment.

Keywords: Fusarium pseudensiforme; Fusarium solani; Neocosmospora pseudensiformis; fusariosis; invasive fungal infection; pulmonary infection.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antifungal Agents / therapeutic use
  • Fatal Outcome
  • Female
  • Fusariosis / diagnosis
  • Fusariosis / drug therapy
  • Fusariosis / microbiology*
  • Fusarium / isolation & purification*
  • Fusarium / pathogenicity
  • Humans
  • Liver Transplantation / adverse effects*
  • Lung Diseases, Fungal / diagnosis
  • Lung Diseases, Fungal / drug therapy
  • Lung Diseases, Fungal / microbiology*
  • Non-alcoholic Fatty Liver Disease / surgery*
  • Radiography / methods
  • Sputum / microbiology
  • Treatment Outcome
  • Voriconazole / therapeutic use

Substances

  • Antifungal Agents
  • Voriconazole

Supplementary concepts

  • Fusarium pseudensiforme