Scedosporium apiospermum and Lichtheimia corymbifera Co-Infection Due to Inhalation of Biogas in Immunocompetent Patients: A Case Series

Abstract

This is the first report describing co-infection of Scedosporium apiospermum and Lichtheimia corymbifera caused by biogas inhalation in two people without underlying medical conditions. Two patients fell into the same pig manure pit at the same time while rescuing another patient (this person died in a few hours) and inhaled biogas. Both patients were diagnosed with pulmonary fungal disease and developed acute liver failure around Day 52. Their results were negative for the 1,3-β-d-glucan test and weakly positive for the galactomannan test. They were treated with amphotericin B and/or posaconazole without surgery. The patient in case 2 required amphotericin B deoxycholate aerosol inhalation to complete the treatment. Both patients recovered completely. For patients with mucormycosis confined to the lungs who cannot tolerate intravenous drip amphotericin B, increasing the dose of nebulised administration maybe a salvage regimen.

Keywords:

• Scedosporium apiospermum
• pulmonary mucormycosis
• acute liver failure
• Lichtheimia corymbifera
• immunocompetent patients
• inhalation of biogas

Abbreviations

CT, computerised tomography; MALDI-TOF, matrix-assisted laser desorption ionization time of flight mass spectrometry; D-AMB, amphotericin B deoxycholate; G-test, 1,3-β-d-glucan test; GM, galactomannan; L-AMB, amphotericin B liposome.

Data Sharing Statement

The datasets generated and/or analyzed during the current study are not publicly available since the patient’s medical records and data are private, but can be made available from the corresponding author on reasonable request under the consent from the patients.

Compliance with Ethics Guidelines

This study was conducted following the legal requirements and the Declaration of Helsinki and its subsequent amendments. Written informed consent for publication was obtained from the patients, including consent to publish accompanying images. According to the hospital protocol, no formal ethics approval was required for this study.

Acknowledgments

We would like to thank the patients for their approval of this paper.

Disclosure

The authors declare that they have no competing interests.

Additional information

Funding

There is no funding to report.