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Case Report

Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation

by
Břetislav Lipový
1,2,
Filip Raška
1,
Iva Kocmanová
3,
Markéta Hanslianová
4,
Martin Hladík
1,*,
Jakub Holoubek
1,
Matěj Bezdíček
5 and
Ctirad Macháček
6
1
Department of Burns and Plastic Surgery, Institution Shared with University Hospital Brno, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
2
CEITEC—Central European Institute of Technology, Brno University of Technology, 612 00 Brno, Czech Republic
3
Department of Clinical Microbiology, University Hospital Brno, 625 00 Brno, Czech Republic
4
Department of Clinical Microbiology, Vyškov Hospital, 628 01 Vyškov, Czech Republic
5
Centre of Molecular Biology and Gene Therapy, Department of Internal Medicine—Hematology and Oncology, Institution Shared with University Hospital Brno, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
6
Department of Pathology, Institution Shared with University Hospital Brno, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
*
Author to whom correspondence should be addressed.
J. Fungi 2021, 7(6), 487; https://doi.org/10.3390/jof7060487
Submission received: 8 April 2021 / Revised: 3 June 2021 / Accepted: 14 June 2021 / Published: 18 June 2021
(This article belongs to the Section Fungal Pathogenesis and Disease Control)
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Abstract

Infectious complications are responsible for the majority of mortalities and morbidities of patients with critical burns. Although bacteria are the predominant etiological agents in such patients, yeasts and fungi have become relatively common causes of infections over the last decade. Here, we report a case of a young man with critical burns on 88% TBSA (total body surface area) arising as a part of polytrauma. The patient’s history of orthotopic liver transplantation associated with the patient’s need to use combined immunosuppressant therapy was an additional complication. Due to deep burns in the forearm region, we have (after a suitable wound bed preparation) applied a new bi-layered dermal substitute. The patient, however, developed a combined fungal infection in the region of this dermal substitute caused by Trichoderma longibrachiatum and Aspergillus fischeri (the first case ever reported). The infection caused the loss of the split-thickness skin grafts (STSGs); we had to perform repeated hydrosurgical and mechanical debridement and a systemic antifungal treatment prior to re-application of the STSGs. The subsequent skin transplant was successful.
Keywords: dermal substitute; infection; Trichoderma; Aspergillus; critical burns; liver transplantation; immunosuppression dermal substitute; infection; Trichoderma; Aspergillus; critical burns; liver transplantation; immunosuppression

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MDPI and ACS Style

Lipový, B.; Raška, F.; Kocmanová, I.; Hanslianová, M.; Hladík, M.; Holoubek, J.; Bezdíček, M.; Macháček, C. Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation. J. Fungi 2021, 7, 487. https://doi.org/10.3390/jof7060487

AMA Style

Lipový B, Raška F, Kocmanová I, Hanslianová M, Hladík M, Holoubek J, Bezdíček M, Macháček C. Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation. Journal of Fungi. 2021; 7(6):487. https://doi.org/10.3390/jof7060487

Chicago/Turabian Style

Lipový, Břetislav, Filip Raška, Iva Kocmanová, Markéta Hanslianová, Martin Hladík, Jakub Holoubek, Matěj Bezdíček, and Ctirad Macháček. 2021. "Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation" Journal of Fungi 7, no. 6: 487. https://doi.org/10.3390/jof7060487

APA Style

Lipový, B., Raška, F., Kocmanová, I., Hanslianová, M., Hladík, M., Holoubek, J., Bezdíček, M., & Macháček, C. (2021). Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation. Journal of Fungi, 7(6), 487. https://doi.org/10.3390/jof7060487

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