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The first described case of Fomitiporella micropora infection in humans: A heart transplant recipient diagnosed by fungal PCR

Summary

A heart transplant patient developed a slow-growing lump on his shin that turned out to be caused by a rare fungus never before seen in humans. Doctors removed the lump surgically and used advanced genetic testing to identify the unusual fungus as Fomitiporella micropora. The patient received antifungal medication and the wound healed completely, highlighting how modern genetic tests can identify rare infections that traditional methods might miss.

Background

Immunocompromised individuals, particularly solid organ transplant recipients on long-term immunosuppressive therapy, are at heightened risk for fungal infections. While infections by common fungi like Candida, Cryptococcus, and Aspergillus are well-documented, human infections by unusual basidiomycetes are rarely reported.

Objective

To describe the first documented case of human infection by Fomitiporella micropora, a basidiomycete fungus not previously implicated in human disease, occurring in a heart transplant recipient with a cutaneous nodule.

Results

Histopathology revealed granulomatous inflammation with necrosis and filamentous fungal elements, but species identification was not possible by microscopy alone. Fungal PCR identified the organism as Fomitiporella micropora through 100% identity match to ITS1 sequence in GenBank. The patient was treated with surgical resection and posaconazole, with complete healing of the lesion.

Conclusion

This case represents the first documented human infection by Fomitiporella micropora and highlights the expanding spectrum of basidiomycete infections in immunocompromised hosts. Advanced molecular diagnostic techniques such as fungal PCR and next-generation sequencing are essential for identifying rare fungal pathogens that cannot be distinguished by traditional microscopy and culture methods.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 40918611, DOI: 10.1016/j.mmcr.2025.100728
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