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Sarocladium implicatum: an unusual agent of opportunistic infection in a COVID-19 patient

Summary

A patient hospitalized with severe COVID-19 developed an unusual infection caused by a mold called Sarocladium implicatum, which typically affects plants. Due to weakened immune system from his illness and medications, the fungus spread to his bloodstream and lungs, causing persistent fever and a cavity in his lung. After molecular testing identified the fungus, he was treated with an antifungal medication called voriconazole, which successfully cured the infection.

Background

Sarocladium species are filamentous fungi traditionally associated with plant diseases and rarely cause human infections. Immunosuppressed patients, particularly those with severe COVID-19, are at increased risk for opportunistic fungal infections due to pathophysiological changes including exacerbated inflammatory response and disruption of barrier functions from medical devices.

Objective

To report the first documented case of Sarocladium implicatum infection in a COVID-19 patient and highlight the importance of monitoring opportunistic fungal infections in immunocompromised individuals during pandemics.

Results

A 64-year-old male COVID-19 patient developed severe neutropenia, persistent fever, and a cavitary lung lesion during hospitalization. Sarocladium implicatum was isolated from blood cultures on day 29 of hospitalization. Treatment with voriconazole for 15 days led to successful cure with resolution of pulmonary cavitation at follow-up imaging.

Conclusion

This is the first reported case of S. implicatum infection in a COVID-19 patient, emphasizing the need for molecular identification methods and heightened surveillance for uncommon opportunistic fungi in severely immunocompromised individuals during epidemics and pandemics.
  • Published in:Revista do Instituto de Medicina Tropical de São Paulo,
  • Study Type:Case Report,
  • Source: PMID: 41191720, DOI: 10.1590/S1678-9946202567075
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