A rare case of cutaneous Lagenidium deciduum infection in an 18-year-old female, who was immunocompromised due to relapsed acute myeloid leukemia, has been documented. This case, which is the first reported instance of Lagenidium deciduum infection in an immunocompromised host across all species, sheds light on the emergence of this pathogen in human medical contexts.
The patient initially presented with erythematous cutaneous lesions on her left hip and bilateral buttocks, which progressed in size and coloration over several days. Subsequently, boil-like lesions appeared on her bilateral buttocks. Initially presumed to be of bacterial origin, the lesions failed to respond to treatment with clindamycin and cefepime. Upon further examination, fungal cultures and skin biopsies revealed the presence of aseptate hyphae, prompting a shift in treatment to isavuconazole and amphotericin B due to suspicion of mucormycosis.
The Fungus Testing Laboratory at the University of Texas Health Science Center conducted phenotypic characterization and DNA sequencing, confirming Lagenidium deciduum as the causative fungal organism. All cutaneous lesions were surgically excised, and the patient underwent treatment with micafungin, terbinafine, doxycycline, and azithromycin. Micafungin and terbinafine were maintained until post-transplant engraftment.
This case highlights the successful management of a human Lagenidium infection in an immunocompromised host, achieved through a combination of aggressive surgical intervention and extended antifungal therapy during the prolonged neutropenia associated with allogeneic stem cell transplant. Timely diagnosis and treatment are crucial in preventing disseminated oomycosis.
Further reports of effective therapies are essential to refine the management strategies for this emerging pathogen in human medicine.
