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Black mold in the bag room: First case of Arthrocladium tropicale peritonitis in a peritoneal dialysis patient

Summary

A peritoneal dialysis patient contracted a rare fungal infection caused by Arthrocladium tropicale, a mold found in damp environments and associated with ant nests. The infection was diagnosed through microscopy and genetic testing, revealing resistance to one antifungal drug but susceptibility to amphotericin B. Treatment with this antibiotic and removal of the dialysis catheter led to full recovery, highlighting the importance of keeping medical equipment storage areas dry and pest-free.

Background

Arthrocladium tropicale is a melanized filamentous fungus previously isolated from decaying wood and tropical environments but not previously linked to human disease. This case describes the first documented human infection with A. tropicale in a peritoneal dialysis patient.

Objective

To report and characterize the first case of Arthrocladium tropicale peritonitis in a peritoneal dialysis patient and establish diagnostic and treatment protocols.

Results

Arthrocladium tropicale was identified via rDNA sequencing with 98.8% identity on LSU and 95.6% on ITS regions. The isolate showed resistance to posaconazole but susceptibility to amphotericin B, voriconazole, itraconazole, and isavuconazonium. Treatment with intravenous amphotericin B and prompt catheter removal resulted in full clinical recovery with no recurrence at 10-month follow-up.

Conclusion

This first documented case of A. tropicale peritonitis demonstrates the importance of molecular diagnostics for rare fungi and highlights the critical role of environmental control and pest prevention in peritoneal dialysis settings. Strict environmental hygiene and regular home visits are essential to prevent contamination from opportunistic fungi.
  • Published in:IDCases,
  • Study Type:Case Report,
  • Source: PMID: 41079882, DOI: 10.1016/j.idcr.2025.e02383
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