{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:46:09Z","timestamp":1790934369926,"version":"4.1.0"},"reference-count":24,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,1,7]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>\n                    Immune checkpoint inhibitor immunotherapy enhances T cell activity against cancer cells but often leads to the immune system targeting healthy cells, causing \u2018immune-related adverse events\u2019 (irAEs). We report the case of a man in his 70s with metastatic melanoma being treated with ipilimumab and nivolumab. He presented with febrile neutropenia after lacerating a thumb on his compost bin. The neutrophil count only recovered once oral prednisolone was commenced, indicating a haematological irAE. A restaging Positron Emission Tomography scan revealed intramuscular ring-enhancing collections throughout his body, one of which was aspirated and cultured the fungus\n                    <jats:italic>Lomentospora prolificans<\/jats:italic>\n                    . He was treated with voriconazole plus terbinafine, both of which were later substituted with olorofim due to a voriconazole-induced rash. After 4\u2009months, the collections had resolved on repeat imaging, and olorofim was ceased due to transaminitis. This case highlights neutropenia as a lesser-known adverse effect of immunotherapy and raises awareness about\n                    <jats:italic>L. prolificans<\/jats:italic>\n                    infection.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-268761","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T13:22:52Z","timestamp":1770384172000},"page":"e268761","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Disseminated\n                    <i>Lomentospora prolificans<\/i>\n                    infection in a patient with neutropenia treated with ipilimumab and nivolumab"],"prefix":"10.1136","volume":"19","author":[{"given":"Nicholas William","family":"Dunstan","sequence":"first","affiliation":[{"name":"Royal Perth Hospital, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Owen","family":"Robinson","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"},{"name":"Infectious Diseases, Royal Perth Hospital, Perth, Western Australia, Australia"},{"name":"PathWest Laboratory Medicine, Murdoch, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Walczak","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia"},{"name":"PathWest Laboratory Medicine, Nedlands, Western Australia, Australia"},{"name":"The University of Western Australia, Crawley, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammie","family":"Higgins","sequence":"additional","affiliation":[{"name":"PathWest Laboratory Medicine, Nedlands, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meinolf","family":"Karthaus","sequence":"additional","affiliation":[{"name":"Haematology, Oncology and Palliative Care, MVZ Onkomedeor, Munich-Perlach, Bavaria, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihitha Hashara","family":"Ariyapperuma","sequence":"additional","affiliation":[{"name":"Medical Oncology, Western Australia Country Health Service, Spencer Park, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"2026020605201245000_19.2.e268761.1","doi-asserted-by":"crossref","DOI":"10.1002\/cam4.70379","article-title":"Pan\u2010Cancer Survival Impact of Immune Checkpoint Inhibitors in a National Healthcare System","volume":"13","author":"Miller","year":"2024","journal-title":"Cancer 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Opportunistic Fungal Pathogen","volume":"10","author":"Konsoula","year":"2022","journal-title":"Microorganisms"},{"key":"2026020605201245000_19.2.e268761.7","doi-asserted-by":"crossref","first-page":"67","DOI":"10.3390\/pathogens12010067","article-title":"Lomentospora prolificans Disseminated Infections: A Systematic Review of Reported Cases","volume":"12","author":"Konsoula","year":"2023","journal-title":"Pathogens"},{"key":"2026020605201245000_19.2.e268761.8","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myx113"},{"key":"2026020605201245000_19.2.e268761.9","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00039-07"},{"key":"2026020605201245000_19.2.e268761.10","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1097\/CMR.0000000000000466","article-title":"Skeletal muscle and solitary bone metastases from malignant melanoma: multimodality imaging and oncological outcome","volume":"28","author":"G\u00f3mez-Le\u00f3n","year":"2018","journal-title":"Melanoma 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Cancer","volume":"5","author":"Simonaggio","year":"2019","journal-title":"JAMA Oncol"},{"key":"2026020605201245000_19.2.e268761.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.mib.2010.04.009"},{"key":"2026020605201245000_19.2.e268761.18","doi-asserted-by":"publisher","DOI":"10.1080\/13693780802524506"},{"key":"2026020605201245000_19.2.e268761.19","first-page":"849","article-title":"A breast cancer patient with disseminated scedosporium prolificans infection","volume":"15","author":"Strickland","year":"1998","journal-title":"Infect Med"},{"key":"2026020605201245000_19.2.e268761.20","doi-asserted-by":"publisher","DOI":"10.1086\/320521"},{"key":"2026020605201245000_19.2.e268761.21","doi-asserted-by":"crossref","DOI":"10.3390\/jof6030122","article-title":"Review of the Novel Investigational Antifungal Olorofim","volume":"6","author":"Wiederhold","year":"2020","journal-title":"J Fungi 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Chemother"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268761","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T13:22:55Z","timestamp":1770384175000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268761"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,6]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bcr-2025-268761"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268761","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}