Invasive pulmonary mycosis due to Chaetomium globosum with false‐positive galactomannan test: a case report and literature review

In this case, the authors report Chaetomium globosum as a cause of invasive pulmonary infection in a patient with Wegener's granulomatosis. Fungal hyphae (KOH and Calcofluor) were seen on direct microscopy of lung biopsy sample and bronchoalveolar lavage (BAL) sample. C. globosum isolated on culture clinched the diagnosis of invasive pulmonary infection by Chaetomium spp. A positive galactomannan of serum and BAL was repeatedly seen and was utilised for follow‐up and as prognostic marker in patient management. The patient was successfully treated with liposomal amphotericin B followed by voriconazole. All the Chaetomium infections reported till date since 1980 are reviewed. Chaetomium spp. with its unique ecology has a hidden clinical potential to cause invasive mould infections.

[1]  R. Verma,et al.  Rare case of subcutaneous mycosis with intrathoracic extension due to Chaetomium strumarium , 2015, Clinical and experimental dermatology.

[2]  N. Ahmad,et al.  Chaetomium globosum Cutaneous Fungal Infection Confirmed by Molecular Identification: A Case Report from Malaysia , 2015, Mycopathologia.

[3]  P. Crous,et al.  Chaetomium-like fungi causing opportunistic infections in humans: a possible role for extremotolerance , 2015, Fungal Diversity.

[4]  L. Pagano,et al.  ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi. , 2014, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[5]  B. Stielow,et al.  Phylogenetic Findings Suggest Possible New Habitat and Routes of Infection of Human Eumyctoma , 2013, PLoS neglected tropical diseases.

[6]  M. Suh,et al.  Onychomycosis Caused by Chaetomium globosum , 2013, Annals of dermatology.

[7]  A. Al-Salem,et al.  Chaetomium peritonitis in an immunocompetent patient simulating tuberculous peritonitis: A case report and review of the literature , 2013 .

[8]  É. Cellier,et al.  A case report of a mixed Chaetomium globosum/Trichophyton mentagrophytes onychomycosis. , 2012, Medical mycology case reports.

[9]  P. Thomas,et al.  Keratitis due to Chaetomium sp. , 2012, Case reports in ophthalmological medicine.

[10]  A. Tortorano,et al.  Cross-Reactivity of Fusarium spp. in the Aspergillus Galactomannan Enzyme-Linked Immunosorbent Assay , 2011, Journal of Clinical Microbiology.

[11]  V. Hubka,et al.  Phaeohyphomycosis and onychomycosis due to Chaetomium spp., including the first report of Chaetomium brasiliense infection. , 2011, Medical mycology.

[12]  J. Perfect,et al.  Phaeohyphomycoses (Brown-Black Moulds) , 2011 .

[13]  S. Revankar,et al.  Melanized Fungi in Human Disease , 2010, Clinical Microbiology Reviews.

[14]  R. Sasikala,et al.  Onychomycosis due to ascomycete Chaetomium globosum: a case report. , 2010, Indian journal of pathology & microbiology.

[15]  S. Sanche,et al.  CHAPTER 14 – Dematiaceous fungi , 2009 .

[16]  V. C. Erchiga,et al.  Onychomycosis by Chaetomium spp. , 2009, Mycoses.

[17]  T. Walsh,et al.  Diagnosis of invasive aspergillosis by galactomannan antigenemia detection using an enzyme immunoassay , 2008, European Journal of Clinical Microbiology & Infectious Diseases.

[18]  M. Piepenbring,et al.  Chromoblastomycosis caused by Chaetomium funicola: a case report from Western Panama , 2007, The British journal of dermatology.

[19]  T. Walsh,et al.  Cross-reactivity of non-Aspergillus fungal species in the Aspergillus galactomannan enzyme immunoassay. , 2007, Diagnostic microbiology and infectious disease.

[20]  J. Gené,et al.  First Spanish case of onychomycosis caused by Chaetomium globosum. , 2007, Medical mycology.

[21]  A. Belgaumi,et al.  Invasive chaetomium infection in two immunocompromised pediatric patients. , 2007, The Pediatric infectious disease journal.

[22]  B. Federspiel,et al.  The soil fungusChaetomium in the human paranasal sinuses , 2007, European Archives of Oto-Rhino-Laryngology.

[23]  Ruoyu Li,et al.  A case of subcutaneous phaeohyphomycosis caused by Chaetomium globosum and the sequences analysis of C. globosum. , 2006, Medical mycology.

[24]  R. Porcher,et al.  Occurrence and Kinetics of False-Positive Aspergillus Galactomannan Test Results following Treatment with β-Lactam Antibiotics in Patients with Hematological Disorders , 2006, Journal of Clinical Microbiology.

[25]  E. Baron,et al.  Bipolaris, Exophiala, Scedosporium, Sporothrix, and other dematiaceous fungi. , 2006 .

[26]  M. Aribandi,et al.  Magnetic resonance imaging findings in fatal primary cerebral infection due to Chaetomium strumarium. , 2005, Australasian radiology.

[27]  S. Revankar Dematiaceous fungi , 2007, Seminars in respiratory and critical care medicine.

[28]  M. Miyaji,et al.  Phaeohyphomycosis Caused by Chaetomium Globosum in an Allogeneic Bone Marrow Transplant Recipient , 2004, Mycopathologia.

[29]  M. Pouranik,et al.  Onychomycosis caused by Chaetomium globosum Kunze , 2004, Mycopathologia.

[30]  J. Guarro,et al.  Invasive Mycotic Infections Caused by Chaetomium perlucidum, a New Agent of Cerebral Phaeohyphomycosis , 2003, Journal of Clinical Microbiology.

[31]  E. Piecková In vitro toxicity of indoor Chaetomium Kunze ex Fr. , 2003, Annals of agricultural and environmental medicine : AAEM.

[32]  Hattori,et al.  Case Report. Onychomycosis due to Chaetomium globosum successfully treated with itraconazole , 2000, Mycoses.

[33]  C. Thomas,et al.  Fatal Chaetomium cerebritis in a bone marrow transplant patient. , 1999, Human pathology.

[34]  M. Delain,et al.  Possible role of Chaetomium globosum in infection after autologous bone marrow transplantation , 1999, Intensive Care Medicine.

[35]  K. Guppy,et al.  Cerebral fungal infections in the immunocompromised host: a literature review and a new pathogen--Chaetomium atrobrunneum: case report. , 1998, Neurosurgery.

[36]  L. Balleisen,et al.  Aspergillus fumigatus und Chaetomium homopilatum bei einem Leukämiepatienten. Pathogene Bedeutung von Chaetomium‐Arten , 1997 .

[37]  A. Aptroot,et al.  [Aspergillus fumigatus and Chaetomium homopilatum in a leukemic patient. Pathogenic significance of Chaetomium species]. , 1997, Mycoses.

[38]  C. K. Campbell,et al.  Chaetomium pneumonia in patient with acute myeloid leukaemia. , 1996, Journal of clinical pathology.

[39]  M. Rinaldi,et al.  Fatal cerebral mycoses caused by the ascomycete Chaetomium strumarium , 1995, Journal of clinical microbiology.

[40]  R. Summerbell,et al.  Onychomycosis of the toenails caused by Chaetomium globosum. , 1992, Journal of American Academy of Dermatology.

[41]  L. Ajello,et al.  Cerebral phaeohyphomycosis caused by Chaetomium globosum in a renal transplant recipient , 1989, Journal of clinical microbiology.

[42]  M. Rinaldi,et al.  Opportunistic mycotic infection caused by chaetomium in a patient with acute leukemia , 1983, Cancer.