Volume 28, Number 4—April 2022
Dispatch
Rigidoporus corticola Colonization and Invasive Fungal Disease in Immunocompromised Patients, United States
Table
Characteristics | Patient 1 | Patient 2 |
---|---|---|
Age, y/sex | 43/M | 63/M |
Underlying conditions | Acute myeloid leukemia, chronic granulomatous disease, hematopoietic stem cell transplant | Recurrent lung cancer, chemotherapy |
Clinical manifestations | Hemifacial pain; sinusitis | Right lung nodule |
Identification method | Broad-range fungal PCR, then sequencing from tissue culture for internal transcribed spacer and D1/D2 subregions (98.5%–100% identity) | Broad-range fungal PCR assay, then sequencing from formalin-fixed, paraffin-embedded tissue |
Susceptibility testing | Posaconazole (MIC 8 µg/mL), voriconazole (MIC 0.5 µg/mL), isavuconazole (MIC 1.0 µg/mL) | Not done |
Pathologic diagnosis | Invasive fungal sinusitis | Fungus ball |
Specimen type | Sinus debridement tissue | Lung wedge resection |
Histologic pattern | Hyphae invading vessels and bone | Hyphae in sclerotic cavity; no invasion |
Branching degree | Predominantly 90° | Predominantly 90° |
Clamp connections | Y | N |
Vascular invasion | Y | N |
Treatment | Surgical debridement, amphotericin B, voriconazole, isavuconazole, olorofim | Surgical debridement |
Response | No disease on endoscopy at 6 mo; new pulmonary nodule at 9 mo | No disease after resection |
Outcome | Death from invasive fungal disease aftet 10 mo | Death from recurrent lung cancer after 11 mo |
Page created: February 24, 2022
Page updated: March 19, 2022
Page reviewed: March 19, 2022
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