FATAL PULMONARY INFECTION CAUSED BY THE BASIDIOMYCETE HORMOGRAPHIELLA-ASPERGILLATA

A fatal case of a pulmonary infection caused by Hormographiella asperg illata, the anamorph of the mushroom Coprinus cinereus, is reported fo r a patient receiving treatment for a second relapse of acute lymphobl astic leukemia. The filamentous basidiomycete was identified with rest riction fragment length polymorphism patterns of PCR-amplified interna lly transcribed spacers and small subunit ribosomal DNA with four rest riction enzymes. The patient failed to respond to treatment with ampho tericin B and itraconazole. The fungus was cultured from the lungs at autopsy: the MIC of amphotericin B for the fungus was low (0.5 mg/lite r), and that of itraconazole was high (8 mg/liter).