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Journal of Clinical Microbiology, April 1999, p. 1154-1160, Vol. 37, No. 4
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Fatal Disseminated Trichoderma longibrachiatum Infection in an Adult Bone Marrow Transplant Patient: Species Identification and Review of the Literature

S. Richter,1 M. G. Cormican,1 M. A. Pfaller,1,* C. K. Lee,2 R. Gingrich,2 M. G. Rinaldi,3,4 and D. A. Sutton3

Departments of Pathology1 and Medicine,2 University of Iowa College of Medicine, Iowa City, Iowa 52242, and Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio,3 and Audie L. Murphy Division, South Texas Veterans Health Care System,4 San Antonio, Texas 78284

Received 5 October 1998/Returned for modification 7 November 1998/Accepted 25 November 1998

Trichoderma longibrachiatum was recovered from stool surveillance cultures and a perirectal ulcer biopsy specimen from a 29-year-old male who had received an allogeneic bone marrow transplant for acute lymphoblastic leukemia. The amphotericin B (2.0 µg/ml) and itraconazole (1.0 µg/ml) MICs for the organism were elevated. Therapy with these agents was unsuccessful, and the patient died on day 58 posttransplantation. At autopsy, histologic sections from the lungs, liver, brain, and intestinal wall showed infiltration by branching septate hyphae. Cultures were positive for Trichoderma longibrachiatum. While Trichoderma species have been recognized to be pathogenic in profoundly immunosuppressed hosts with increasing frequency, this is the first report of probable acquisition through the gastrointestinal tract. Salient features regarding the identification of molds in the Trichoderma longibrachiatum species aggregate are presented.

* Corresponding author. Mailing address: Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242. Phone: (319) 394-9566. Fax: (319) 356-4916. E-mail: michael-pfaller{at}uiowa.edu.

Journal of Clinical Microbiology, April 1999, p. 1154-1160, Vol. 37, No. 4
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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