First case of Trichoderma longibrachiatum infection in a renal transplant recipient in Tunisia and review of the literature.

BACKGROUND: Trichoderma species are filamentous fungi that were previously considered to be culture contaminants. Recently, with the increasing number of risk population, they are described as an emerging pathogen in immunocompromised patients. Trichoderma longibrachiatum is the most common species involved in Trichoderma infections. AIM: Here, we report the first case in Tunisia of skin infection caused by Trichoderma longibrachiatum in a renal transplant recipient. CASE: The fungus was isolated from fluid puncture of an inguinal abscess and from skin biopsy from a 46-year-old male patient who had been receiving immunosuppressive therapy. Species identification benefited from a molecular approach. Susceptibility tests performed with the use of the European Committee on Antimicrobial Susceptibility Testing standardized methodology revealed that the organism is resistant to itraconazole, intermediate to amphotericin B and sensitive to voriconazole, posaconazole and caspofungin. The infection was successfully treated with voriconazole.