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

Summary

A patient who received a heart transplant developed a small, slowly-growing lump on his shin over many years. After surgical removal, genetic testing revealed it was caused by a rare fungus never before identified in humans. The surgical removal likely cured the infection, and the case shows how important advanced genetic testing methods are for identifying unusual infections in transplant patients.

Background

Solid organ transplant recipients on immunosuppressive therapy are at heightened risk for fungal infections, including those caused by rare basidiomycetes. 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 case of Fomitiporella micropora infection in humans, identified in a heart transplant recipient with a cutaneous nodule, and to highlight the importance of molecular diagnostics in identifying rare fungal pathogens in immunocompromised hosts.

Results

Fungal PCR identified the organism as Fomitiporella micropora, a basidiomycete never previously reported in human disease. The patient was treated with surgical resection and posaconazole, with complete healing of the lesion by day 89. MRI on day 60 showed no invasive infection or osteomyelitis.

Conclusion

This case represents the first documented human infection caused by Fomitiporella micropora and demonstrates the expanding spectrum of basidiomycete infections in immunocompromised patients. Advanced molecular diagnostics such as fungal PCR and next-generation sequencing are essential for accurate identification of rare fungal pathogens, with surgical resection likely being the curative intervention in this case.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 40918611, DOI: 10.1016/j.mmcr.2025.100728
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