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Ventilator-associated pneumonia caused by a new-found opportunistic fungal pathogen—Myceliophthora heterothallica: a case report

Summary

A 67-year-old woman suffered cardiac arrest and required a breathing machine to survive. While on the ventilator, doctors discovered an unusual fungal infection in her lungs caused by Myceliophthora heterothallica, which had never been documented as a human pathogen before. With standard bacterial antibiotics and supportive care, the patient recovered and was discharged after four weeks, suggesting this fungus may be less dangerous than related species.

Background

Myceliophthora heterothallica is an environmental fungus that has not been previously reported as pathogenic or colonizing in clinical literature. Ventilator-associated pneumonia (VAP) primarily involves bacterial pathogens, though fungal infections may occur in aged patients with underlying diseases.

Objective

To report the first case of ventilator-associated pneumonia caused by Myceliophthora heterothallica in an aged patient and characterize its clinical features, identification methods, and pathogenic mechanisms.

Results

Myceliophthora heterothallica was cultured from endotracheal aspirates on day 5 of mechanical ventilation, alongside carbapenem-resistant Acinetobacter baumannii. Lung CT showed multiple cuneiform nodules with ground-glass opacity. The patient recovered consciousness and was discharged after 28 days of treatment with piperacillin-tazobactam without antifungal therapy.

Conclusion

This is the first reported case of VAP caused by Myceliophthora heterothallica in an aged patient. Although the fungus demonstrated pathogenicity, the clinical course was less severe than related species, suggesting differential virulence and a favorable prognosis with appropriate management of comorbidities.
  • Published in:BMC Geriatrics,
  • Study Type:Case Report,
  • Source: PMID: 39342216, DOI: 10.1186/s12877-024-05369-4
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