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First case of invasive Rasamsonia argillacea in a child with chronic granulomatous disease in Qatar

Summary

A 16-year-old girl with a rare immune system disorder called chronic granulomatous disease developed a serious fungal infection caused by Rasamsonia argillacea, a fungus that is not commonly seen in clinical practice. The infection presented as a painful collection in her chest wall that required surgery and multiple antifungal medications. This is the first reported case of this particular fungal infection in the Arabian Peninsula, and successful treatment required a combination of drugs chosen based on laboratory testing of the fungus’s resistance patterns.

Background

Chronic granulomatous disease (CGD) is a primary immunodeficiency that predisposes patients to life-threatening infections, including invasive fungal infections (IFI). Rasamsonia argillacea is an emerging pathogenic fungus primarily affecting immunocompromised patients, particularly those with CGD and cystic fibrosis.

Objective

To report the first case of invasive Rasamsonia argillacea infection in a CGD patient in the Arabian Peninsula and to review the challenging aspects of identification and treatment of this emerging pathogen.

Results

Rasamsonia argillacea was isolated from wound specimens and identified through molecular and mass spectrometry methods. The isolate showed high MIC values to voriconazole and fluconazole but low MIC to caspofungin. Triple antifungal therapy was initiated and later modified based on susceptibility results; after four months of treatment, imaging showed near-complete resolution of the collection.

Conclusion

This is the first reported case of R. argillacea IFI in CGD in the Arabian Peninsula. Rasamsonia species should be suspected in CGD patients with fungal infections, and genotypic methods are necessary for accurate identification due to morphological similarities to other fungi. Further studies are needed to establish optimal treatment protocols.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 40018081
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