ArticleBMC infectious diseases2026
Trichoderma harzianum fungemia following COVID-19-related immune dysregulation in an immunocompetent patient: a case diagnosed by mNGS.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTrichoderma harzianum is a filamentous saprophytic fungus rarely implicated in human infections. Invasive Trichoderma infections are uncommon and are typically observed in immunocompromised hosts. CASE PRESENTATION: We report a 68-year-old immunocompetent male farmer who developed persistent fever and dizziness after COVID-19 infection. Initial empirical antibacterial and antiviral therapy failed to relieve symptoms. Repeated blood cultures and serological fungal tests were negative, whereas metagenomic next-generation sequencing (mNGS) of whole blood identified T. harzianum sequences (794 reads), confirming fungemia. The patient experienced severe infusion reactions to amphotericin B and visual disturbances with voriconazole, but responded well to posaconazole therapy. Fever subsided within seven days, mNGS sequence reads declined markedly, and no recurrence occurred during 12 weeks of follow-up.
conclusionsThis case represents the first documented instance of T. harzianum fungemia in an immunocompetent individual following transient immune dysregulation associated with COVID-19. The report underscores the diagnostic value of mNGS in detecting rare opportunistic fungi when conventional cultures are negative and highlights posaconazole as a potential therapeutic option.
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