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Case Reports
. 2025 Jun 14:49:100709.
doi: 10.1016/j.mmcr.2025.100709. eCollection 2025 Sep.

Invasive Trichoderma longibrachiatum breakthrough infection in a hematology patient

Yuri Vanbiervliet  1   2 , Robina Aerts  1   2   3 , Ellen Boon  1 , Toine Mercier  2   4 , Ann-Sophie Jacob  5 , Marijke Peetermans  2   6 , Koen Debackere  1   7 , Katrien Lagrou  2   5 , Johan Maertens  1   2
Affiliations
Case Reports

Invasive Trichoderma longibrachiatum breakthrough infection in a hematology patient

Yuri Vanbiervliet et al. Med Mycol Case Rep. .

Abstract

Trichoderma species are emerging as pathogens, causing invasive fungal infections, particularly in immunocompromised individuals. We report the case of a 61-year-old neutropenic female with hepatosplenic T-cell lymphoma and profound neutropenia, who developed a breakthrough infection with Trichoderma longibrachiatum while receiving liposomal amphotericin B for probable invasive pulmonary aspergillosis. Despite combination antifungal therapy the patient ultimately succumbed to multiple organ failure. Trichoderma longibrachiatum and Aspergillus fumigatus were identified as causative fungal pathogens. Antifungal susceptibility testing of the T. longibrachiatum isolate revealed resistance to isavuconazole but susceptibility to amphotericin B, voriconazole, itraconazole and olorofim.

Keywords: Aspergillus fumigatus; Fungal co-infection; Hematology; Invasive mould infections; Olorofim; Trichoderma longibrachiatum.

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Conflict of interest statement

The authors declare that they have no conflicts of interest related to this manuscript.

Figures

Fig. 1
Fig. 1
Radiological signs on chest CT.
Fig. 2
Fig. 2
Mycological kinetics. All fungal cultures on BALF positive for fungi. Last four cultures grew T. longibrachiatum. Aspergillus species has not been cultured. Zero value for Aspergillus PCR and beta-D-glucan means ‘negative’. D7 is day of admission to the Intensive Care Unit, day 34 is day of death. Figure created in https://marpledata.com.
Fig. 3
Fig. 3
Macroscopy and microscopy of the isolate in casu.
See this image and copyright information in PMC

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