Fungal sternal wound infection due to Curvularia lunata in a neonate with congenital heart disease: case report and review

Abstract

We describe a neonate with congenital heart disease in whom a sternal wound infection caused by the filamentous fungus Curvularia lunata developed following cardiac surgery. Despite their widespread distribution in the environment, Curvularia species rarely cause human infection. We also review the 43 cases of curvularia infection previously reported in the English-language literature; only four of these cases occurred in children. A wide spectrum of infections--including keratitis, cutaneous infections, sinusitis, allergic bronchopulmonary disease, pneumonia, chronic ambulatory peritoneal dialysis-related infections, endocarditis and disseminated infections--have been described. Curvularia is a pathogen that can cause disease in both immunocompetent and immunocompromised hosts, although more severe and disseminated disease occurs in patients with defective immune function. Surgery alone usually is successful for treating locally invasive disease, although a combination of medical and surgical therapy is necessary for treating disseminated infections.