Fatal disseminated infection due to Sarocladium kiliense in a diabetic patient with COVID-19

Abstract

Sarocladium kiliense is a soil saprophytic mold with worldwide distribution, which can infect humans and other mammals, sporadically. The clinical manifestations include mycetoma, onychomycosis, keratomycosis, pneumonia, and arthritis. Here, we present a disseminated infection due to S. kiliense in a diabetic patient infected to coronavirus disease 2019 (COVID-19) from Isfahan, Iran.

Keywords: COVID‐19; Sarocladium kiliense; diabetic patient; disseminated infection.

FIGURE 1

Primary lesion in the big toe A, the lesion after treatment with medicinal herbs B, progressive lesion (grade 3, stage D) for which the patient referred to the hospital C

FIGURE 2

Septate hyaline fungal hyphae in histopathological findings, Periodic Acid‐Schiff (PAS) Stain, original magnification ×40

FIGURE 3

Amputation of big toe due to the grade 3, stage D lesion A, amputation of foot because of progressive necrotic lesion B

FIGURE 4

Chest computed tomography (CT) scan revealed diffuse ground‐glass opacity in both lungs with crazy‐paving in favor of COVID‐19 pneumonia

FIGURE 5

White to pink slow‐growing colonies of S. kiliense that often compact and moist at first, then becoming floccose or suede‐like with age A, fine and hyaline hyphae producing simple awl‐shaped erect phialides with one‐celled hyaline conidia B