Hormographiella aspergillata : an emerging basidiomycete in the clinical setting? A case report and literature review
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CASE REPORT
Open Access
Hormographiella aspergillata: an emerging basidiomycete in the clinical setting? A case report and literature review Maxime Moniot1,2* , Rose-Anne Lavergne3, Thomas Morel1, Romain Guieze4, Florent Morio3, Philippe Poirier1,2 and Céline Nourrisson1,2
Abstract Background: Filamentous basidiomycetes are mainly considered to be respiratory tract colonizers but the clinical significance of their isolation in a specimen is debatable. Hormographiella aspergillata was first reported as a human pathogen in 1971. We discuss the role of this mold as a pathogen or colonizer and give an update on diagnostic tools and in vitro antifungal susceptibility. Case presentation: We identified three cases of H. aspergillata with respiratory symptoms in a short period of time. One invasive infection and two colonizations were diagnosed. Culture supernatants showed that H. aspergillata can produce galactomannan and β-D-glucan but not glucuronoxylomannan. For the first time, isavuconazole susceptibility was determined and high minimum inhibitory concentrations (MICs) were found. Liposomal amphotericin B and voriconazole have the lowest MICs. Conclusion: To date, 22 invasive infections involving H. aspergillata have been reported. On isolation of H. aspergillata, its pathogenic potential in clinical settings can be tricky. Molecular identification and antifungal susceptibility testing are essential considering high resistance against several antifungal therapies. Keywords: Hormographiella aspergillata, Coprinus cinereus, Mould, Antifungal susceptibility, Fungal colonization, Basidiomycete
Background Filamentous basidiomycetes are mainly considered to be respiratory tract colonizers but increasingly these molds are being documented in invasive infections [1]. Hence, the clinical significance of their isolation in a specimen is debatable. Hormographiella aspergillata is a filamentous basidiomycete growing on horse dung. It was found in * Correspondence: [email protected] 1 Laboratoire de Parasitologie-Mycologie, CHU Clermont-Ferrand, CHU Gabriel Montpied, 58 rue Montalembert, 3IHP, 63003 Clermont-Ferrand Cedex 1, France 2 Equipe Interactions Hôte-Parasite, Laboratoire Microorganismes : Génome et Environnement, CNRS, Université Clermont-Auvergne, Clermont-Ferrand, France Full list of author information is available at the end of the article
numerous environmental substrates and first reported as a human pathogen in 1971 [2–4]. Since, a few infections were reported all over the world with various clinical outcomes, essentially pulmonary but also disseminated or located to the eye or the skin [2, 5–22]. Thus, data are sparse for the diagnosis and management of such infections. Here, we report a new case of human infection involving H. aspergillata and two cases of colonization. We then review all previously published cases and discuss diagnostic strategy and clinical management.
Case presentation The first case (HA1) was an 70-year-old man admitted to the hematology department for prolonged febrile
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