Lab Med Online.  2022 Jul;12(3):195-200. 10.47429/lmo.2022.12.3.195.

The First Case of Coniochaeta hoffmannii Fungemia and Literature Review

• Hong Y
• Kim D
• Park K
• Sung H
• Kim MN

• KMID: 2538605
• DOI: http://doi.org/10.47429/lmo.2022.12.3.195

Abstract

Coniochaeta hoffmannii (formerly, Lecythophora hoffmannii) is a soil-inhabiting plant pathogen in the class of Sordariomycetes. Coniochaeta species are rare and opportunistic and cause subcutaneous infections, keratitis, sinusitis, and peritonitis. Only three cases of human infection by C. hoffmannii have been reported worldwide. A 61-year-old woman with advanced endometrioid adenocarcinoma developed a fever of 39.2°C. Her chest computed tomography (CT) revealed multiple irregular nodules in both lungs, suggesting septic embolism, fungal infection, or less likely, metastasis. Blood cultures performed using a set of blood samples drawn from the central venous catheter showed the presence of Clostridium baratii and C. hoffmannii. Ceftriaxone was administered for 2 days and piperacillin-tazobactam was administered for 6 days after removing the central line. Her fever subsided the next day after febrile onset. Cultures obtained from the central line tip showed no growth. The follow-up CT performed two months later revealed variable changes in the size of the previous nodules and multiple new nodules accompanying the inflammatory lesions. The central venous catheter or pulmonary fungal infections are the suspected source of this rare case of fungemia; this represents the first reported case of C. hoffmannii fungemia.

Keyword

Coniochaeta hoffmannii; Fungemia; Central line; Pulmonary nodule

Figure

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  Fig. 1 Clinical and laboratory findings of the case during hospitalization. Chest computed tomography showed multiple irregular nodules in both lungs on day 2 (indicated using arrow heads) (A), which decreased in size and number (B) on day 10.

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  Fig. 2 Microbiological findings of Coniochaeta hoffmannii isolated from this case. Colonies grown on Sabouraud Dextrose agar incubated at 30°C for 2 days (A), 4 days (B), 7 days (C), and 14 days (D). Microscopy analysis of the slide culture of Coniochaeta hoffmannii showed oval conidia (1.5–2.5×3.0–6.0 μm) (E, F) and flask-shaped phialide (indicated using arrows) with an erupted short neck (G, H) (Periodic acid-Schiff stain, ×1,000).

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