Lomentospora prolificans infective endocarditis and cerebral mycotic aneurysm

TL;DR

A rare case of Lomentospora prolificans infection in a partially immunocompromised patient was successfully treated with surgery and olorofim.

Contribution

Reports a rare survival case of L. prolificans infection with minimal immunosuppression and normal-appearing infected sites.

Findings

Patient survived L. prolificans infection after allogeneic stem cell transplant with early surgery and olorofim.

Infection occurred at sites that appeared normal during surgery and imaging.

Case demonstrates possible effectiveness of olorofim in treating this deadly fungal infection.

Abstract

Disseminated Lomentospora prolificans infection typically occurs in immunocompromised hosts and is almost universally fatal. We describe a case of L. prolificans native valve infective endocarditis with cerebral mycotic aneurysm after recovery from allogeneic stem cell transplant. The case is notable for minimal immunosuppression at diagnosis, and pathological evidence of infection at sites which looked normal at surgery or by imaging. With early surgery and olorofim the patient survived to 76 days after diagnosis.

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