title: Fatal necrotizing stomatitis due to Trichoderma longibrachiatum in a neutropenic patient with malignant lymphoma: a case report.
abstract: Primary invasive mold infection of the oral cavity is a rare but serious complication in immunocompromised hosts. We report a case of fatal Trichoderma longibrachiatum stomatitis in a 66-year-old female patient with malignant lymphoma. The infection rapidly disseminated from the oral mucosa to the lungs during neutropenia. Despite intensive antifungal therapy with amphotericin B and itraconazole, there was a fatal progression of the condition. While Trichoderma species have been recognized to be pathogenic in profoundly immunosuppressed hosts, this is the first report of the primary oral focus causing a fatal infection.
authors.affiliation: Department of Oral Surgery, Hiroshima Red Cross and Atomic Bomb Survivors Hospital, Hiroshima, Japan. myoken@do5.enjoy.ne.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Myoken
authors.forename: T
authors.initials: T
authors.lastname: Sugata
authors.forename: Y
authors.initials: Y
authors.lastname: Fujita
authors.forename: H
authors.initials: H
authors.lastname: Asaoku
authors.forename: M
authors.initials: M
authors.lastname: Fujihara
authors.forename: Y
authors.initials: Y
authors.lastname: Mikami
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D005892:Gingivitis, Necrotizing Ulcerative / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D017964:Itraconazole / Q000627:therapeutic use; D008172:Lung Diseases, Fungal / Q000382:microbiology; D016393:Lymphoma, B-Cell / Q000188:drug therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy*; D009181:Mycoses / Q000382:microbiology*; D009503:Neutropenia / Q000209:etiology*; D009894:Opportunistic Infections / Q000382:microbiology; D013280:Stomatitis / Q000382:microbiology*; D014242:Trichoderma
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B