Department of Laboratory Medicine, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun City, Jilin Province, 130021, China.
Pathogenobiology, Jilin University Mycology Research Center, Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, No. 126 Xinmin Street, Changchun City, Jilin Province, 130021, China.
BMC Geriatr. 2024 Sep 28;24(1):790. doi: 10.1186/s12877-024-05369-4.
Myceliophthora heterothallica belonging to Myceliophthora is considered as an environmental fungus and has not been reported to be pathogenic or colonizing in recent literature. The present case firstly reports a ventilation-associated pneumonia caused by Myceliophthora heterothallica among the aged adult.
A 67-years-old Asian female patient suffering from a sudden disturbance of consciousness for 3 h was admitted to our hospital. Cardiac arrest occurred during emergency transport, and sinus rhythm was restored after cardiopulmonary resuscitation. Invasive mechanical ventilation was given to this patient for respiratory failure. After mechanical ventilation, the lung CT images showed multiple cuneiform nodules arranging subpleural accompanying with ground-glass opacity. On the 5th day of mechanical ventilation, Myceliophthora heterothallica was cultured from endotracheal aspirates. Two methods, namely automatic microbial identification system and internal transcribed spacer sequencing were employed to identify this fungus. The present case firstly uncovered the colonization ability and pathogenicity of Myceliophthora heterothallica in the respiratory tract. After 28d of treatment with piperacillin-tazobactam, this patient weaned from the ventilator and recovered from consciousness with lung infection disappearance.
This is the first case report of ventilation-associated pneumonia in the aged patient caused by Myceliophthora heterothallica. This current case is worth for the clinical diagnosis and treatment of Myceliophthora heterothallica infection, and also enriches new pathogenic species found of thermothelomyces species.
嗜热毁丝霉属于嗜热真菌，在最近的文献中没有被报道为致病菌或寄生菌。本病例首次报告了一例老年成人由嗜热毁丝霉引起的与通气相关的肺炎。
一名 67 岁的亚洲女性患者，突发意识障碍 3 小时，被收入我院。在紧急转运过程中心脏骤停，心肺复苏后恢复窦性心律。患者因呼吸衰竭给予有创机械通气。机械通气后，肺部 CT 图像显示多个楔形结节排列于胸膜下，伴有磨玻璃影。在机械通气的第 5 天，从气管内吸出物中培养出嗜热毁丝霉。使用自动微生物鉴定系统和内部转录间隔区测序两种方法对该真菌进行鉴定。本病例首次揭示了嗜热毁丝霉在呼吸道的定植能力和致病性。经过 28 天的哌拉西林他唑巴坦治疗，该患者成功脱机并恢复意识，肺部感染消失。
这是首例嗜热毁丝霉引起老年患者通气相关肺炎的病例报告。本病例值得临床诊断和治疗嗜热毁丝霉感染，并丰富了嗜热丝孢酵母属新的致病种。
