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

Summary

A 64-year-old man hospitalized with COVID-19 developed a serious fungal infection from Sarocladium implicatum, an unusual fungus rarely found in humans. The infection appeared in his bloodstream and lungs while his immune system was severely weakened by the virus and medications. Doctors identified the fungus using genetic testing and successfully treated him with voriconazole antifungal medication. This case highlights how COVID-19 patients in intensive care are vulnerable to rare opportunistic infections that require specialized laboratory testing to identify and treat.

Background

Sarocladium species are filamentous fungi traditionally associated with plant diseases and rarely cause human infections. Immunosuppressed patients are at increased risk for hyalohyphomycosis caused by Sarocladium species. COVID-19 patients in intensive care may develop opportunistic fungal infections due to pathophysiological changes and immunosuppression.

Objective

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

Results

Sarocladium implicatum was isolated from blood cultures on day 29 of hospitalization with 100% identity to GenBank reference sequence. Antifungal susceptibility testing showed MIC of 4 µg/mL for amphotericin B and 8 µg/mL for voriconazole. Patient was successfully treated with voriconazole 200 mg orally every 12 hours for 15 days with clinical improvement and resolution of pulmonary cavitation.

Conclusion

This is the first reported case of Sarocladium implicatum infection in a COVID-19 patient. Molecular identification combined with traditional culture-based techniques is essential for accurate diagnosis of Sarocladium species. The emergence of Sarocladium as a nosocomial pathogen in COVID-19 patients warrants heightened clinical awareness and proper laboratory identification protocols.
  • 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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