Acremonium Potronii Associated Pneumonia in an Allogeneic Stem Cell Transplantation Recipient
Abstract
Infections are one of the major causes of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. Clinically significant graft versus host disease, steroid therapy, cytomegalovirus infection, recurrent neutropenia and relapsed/refractory disease are the recognized risk factors for invasive fungal infections. Acremonium, which is a large polyphyletic fungal genus, is present in soil, insects, plants and other environmental substrates. Disseminated infections are rare with the reported cases limited to immunocompromised patients with a large clinical spectrum including pneumonia, arthritis, osteomyelitis, endocarditis, peritonitis, meningitis and sepsis. Acremonium species present low susceptibility to most antifungals including imidazoles, fluorocytosine and amphotericin B. For the clinically relevant species, the minimum inhibitory concentrations for all antifungal agents are high, except terbinafine. As Acremonium spp grow slowly, cultures should be kept for at least 2 weeks to ensure detection of a positive sample. Clinicians should be aware that Acremonium spp, particularly A. Potronii, might be one of the causative fungi of systemic infection in severely immunocompromised allogeneic hematopoietic stem cell transplantation recipients.
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