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Schizophyllum radiatum: An uncommon culprit of invasive fungal rhinosinusitis in an immunocompetent patient – A case report from India

Summary

A 32-year-old healthy woman in India developed a serious fungal infection in her sinuses caused by an unusually rare fungus called Schizophyllum radiatum. Doctors removed the infected material through surgery and identified the fungus using genetic sequencing when standard methods failed. Treatment with antifungal medication successfully cleared the infection, and the patient fully recovered.

Background

Schizophyllum species are emerging human respiratory pathogens, with Schizophyllum commune being the most commonly reported. Invasive fungal rhinosinusitis caused by S. radiatum is extremely uncommon, with only a few clinical isolates documented globally. This case represents likely the first documented instance of S. radiatum invasive fungal rhinosinusitis in India.

Objective

To report a rare case of invasive fungal rhinosinusitis caused by Schizophyllum radiatum in a young immunocompetent female patient. The case demonstrates the importance of genomic sequencing for identification of non-sporulating molds that cannot be definitively identified by conventional morphological methods.

Results

Microscopic examination revealed thin septate hyaline hyphae. Culture yielded confluent white cottony flat mold growth with sterile hyphae without sporulation. MALDI-TOF-MS failed to provide conclusive identification, but ITS sequencing confirmed 99.48% identity with S. radiatum. Post-operative treatment with oral Itraconazole resulted in complete resolution with normal sinonasal mucosa at follow-up.

Conclusion

This case highlights the critical need for greater awareness and precise molecular identification of rare basidiomycetous fungi in human infections. The successful identification via ITS sequencing emphasizes the importance of genomic methods for non-sporulating molds that cannot be distinguished by morphological characteristics alone. Further studies incorporating multiple gene targets are needed to enhance understanding of S. radiatum as an emerging fungal pathogen.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: 10.1016/j.mmcr.2025.100732, PMID: 41035661
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