Phaeohyphomycosis in a Solid Organ Transplant Recipient: Case Report of a New Pathogenic Species of Kirschsteiniothelia.
Rihab Trabelsi, Melissa Zlobecki, Maxime Moniot et al.
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Case in brief
A 63-year-old immunocompromised recipient of a combined heart-lung transplant developed a subcutaneous thigh lesion. Surgical debridement and histopathology indicated a deep fungal infection. Three years later, the lesion relapsed; biopsy with microbiological and histopathological analysis identified phaeohyphomycosis caused by a dematiaceous fungus in the genus Kirschsteiniothelia, not previously known as a human pathogen. Retrospective examination of the original formalin-fixed biopsies found the same fungus, supporting chronic, progressive infection over the intervening three years.
What made this case unusual
The infection was attributed to an undescribed Kirschsteiniothelia fungus not previously known as a human pathogen, and retrospective analysis linked it to the original lesion.
Diagnostic / clinical pearl
In a transplant recipient with a persistent or relapsing subcutaneous lesion, combining histopathology with mycological analysis can identify an unusual dematiaceous fungal cause; archived tissue may help clarify the diagnosis.