{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:25:16Z","timestamp":1790364316028,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T00:00:00Z","timestamp":1613606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Lomentospora prolificans<\/jats:italic> (formerly <jats:italic>S prolificans<\/jats:italic>) is a saprophyte fungi that causes opportunistic infections in solid organ transplant (SOT) recipients. Resulting disseminated infections are difficult to treat and have a high mortality. Indications for antifungal prophylaxis after heart transplantation (HT) include CMV disease, reoperation, renal replacement therapy, extracorporeal membrane oxygenation (ECMO), and high environmental exposure to <jats:italic>Aspergillus<\/jats:italic> spores. However, the risk of breakthrough infections, such as <jats:italic>Lomentosporiosis,<\/jats:italic> remains a cause of concern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We report the clinical findings, microbiology, treatment and outcome of a disseminated Lomentosporiosis in a heart transplant recipient with ECMO and antifungal prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A 25\u2010year\u2010old male with complex grown\u2010up congenital heart disease (GUCHD) was admitted for HT. He presented severe post\u2010surgical complications including acute kidney injury and right heart and respiratory failure requiring venoarterial\u2010ECMO, continuous renal replacement therapy (CCRT) and later on (+14) a ventricular assist device (VAD). Ganciclovir, cotrimoxazole, and antifungal prophylaxis with anidulafungin at standard doses had been started on day\u00a0+\u00a03 post HT. The patient presented seizures (+4), pancytopenia with mild neutropenia (days\u00a0+\u00a06 to\u00a0+\u00a011), influenza B (+7), and bacteremic <jats:italic>Pseudomonas aeruginosa<\/jats:italic> ventilator associated pneumonia (VAP) (+10). On days\u00a0+\u00a014 to\u00a0+\u00a016 <jats:italic>Lomentospora prolificans<\/jats:italic> was recovered from blood cultures, broncho aspirate, catheter tip, and skin biopsy. Despite treatment with L\u2010AMB, voriconazole and terbinafine the patients died on day 17 after HT. Necropsy revealed disseminated infection with fungal invasion in central nervous system, heart, lung, cutaneous, and subcutaneous tissue. Broth microdilution tests demonstrated resistance to all antifungals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>Lomentosporiosis<\/jats:italic> is a rare complication that may emerge as a breakthrough invasive fungal infection in heart transplant recipients on ECMO despite antifungal prophylaxis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13574","type":"journal-article","created":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T21:41:37Z","timestamp":1612388497000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Disseminated lomentosporiosis in a heart transplant recipient: Case report and review of the literature"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6394-2861","authenticated-orcid":false,"given":"Maricela","family":"Valerio","sequence":"first","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases 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