, Volume 181, Issue 11–12, pp 901–908 | Cite as

Invasive Fungal Sinusitis by Lasiodiplodia theobromae in an Patient with Aplastic Anemia: An Extremely Rare Case Report and Literature Review

  • Hyun Jung Gu
  • Young Jin Kim
  • Hee Joo Lee
  • Sung Hwa Dong
  • Sung Wan Kim
  • Hee Jae Huh
  • Chang-Seok Ki


Human Lasiodiplodia theobromae infection has not been reported frequently. We report the first case of invasive L. theobromae nasal and neck infection. A 66-year-old male visited our hospital with anemia and general weakness. He showed pancytopenia, and his bone marrow examination revealed markedly decreased hematopoietic cells. The patient was presumed to have iatrogenic aplastic anemia due to mushroom toxicity. He began treatment for multiple organ infections with broad-spectrum antibiotics and antifungal agents. During hospitalization, he complained of nasal obstruction and left neck lymph node enlargement. A mass-like lesion was observed, and a nasal mass biopsy was performed. The mass was identified as a fungal ball. He underwent surgical excision for the nasal mass and the neck lymph node. The pathologic examination indicated an invasive fungal infection, and the lymph node revealed chronic granulomatous inflammation with fungal infection. 18s rRNA sequencing revealed that the sequence shared 99 % identity with L. theobromae. The nasal mass fungus was identified by internal transcribed spacer region sequencing from pathologic paraffin sections. The obtained sequence corresponded to Lasiodiplodia or Macrophoma. The sequence corresponded to the neck discharge sequence results. Hence, the patient was diagnosed with invasive fungal sinusitis with neck lymph node involvement caused by L. theobromae. To our knowledge, this is the first report of L. theobromae infection in Korea and the first report of invasive L. theobromae fungal sinusitis in the literature. We should include more precise evaluations of additional novel fungal species as possible candidates.


Lasiodiplodia theobromae Invasive fungal infection Nasal fungal mass Sinusitis Opportunity infection 


Compliance with Ethical Standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Human Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This reporting case is a retrospective study, and thus for this type of study formal consent is not required.

Welfare of animals

This article does not contain any studies with human participants performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Hyun Jung Gu
    • 1
  • Young Jin Kim
    • 1
  • Hee Joo Lee
    • 1
  • Sung Hwa Dong
    • 2
  • Sung Wan Kim
    • 2
  • Hee Jae Huh
    • 3
  • Chang-Seok Ki
    • 3
  1. 1.Department of Laboratory MedicineKyung Hee University School of MedicineSeoulKorea
  2. 2.Department of Otolaryngology-Head and Neck SurgeryKyung Hee University School of MedicineSeoulKorea
  3. 3.Department of Laboratory Medicine and Genetics, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea

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