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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 extremely rare fungus called Schizophyllum radiatum. Standard laboratory tests could not identify the fungus due to its unusual characteristics, so doctors used advanced DNA sequencing to confirm the diagnosis. After surgery to remove the infected material and treatment with antifungal medication, the patient fully recovered, marking this as likely the first documented case of this type of infection in India.

Background

Schizophyllum species are emerging human respiratory pathogens that are rarely identified as human pathogens due to challenges in identification. While Schizophyllum commune is the most commonly reported species, infections caused by S. radiatum are extremely uncommon with only a few clinical isolates documented in literature.

Objective

To report what is likely the first documented case of invasive fungal rhinosinusitis caused by S. radiatum in India and to highlight the importance of genomic sequencing for identification of non-sporulating molds in rare fungal infections.

Results

Direct microscopy revealed thin septate hyphae and culture showed confluent white cottony mold growth. The isolate lacked characteristic morphological features and MALDI-TOF-MS failed to provide conclusive identification. ITS region sequencing confirmed 99.48% identity with S. radiatum. Post-operative itraconazole treatment resulted in complete resolution with normal sinonasal mucosa at six-month follow-up.

Conclusion

This case documents the first known instance of invasive fungal rhinosinusitis caused by S. radiatum in India and emphasizes the critical need for molecular identification techniques in diagnosing rare basidiomycetous fungi. The case also demonstrates that invasive fungal rhinosinusitis can occur in immunocompetent individuals, contrary to typical patterns seen with other fungal pathogens.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: 10.1016/j.mmcr.2025.100732, PMID: 41035661
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