CONICET | Buscador de Institutos y Recursos Humanos

OBJETIVEChaetomium is a genus of the family Chaetomiaceae It is present in soilvegetables, cellulose residues and other substrates Infections caused by some Chaetomiumspecies have been described in both immunocompetent and immunocompromised hosts Wereport a case of nasal infection by Chaetomium sp in an immunocompetent patientMETHODOLOGYA 50 year old male patient had severe facial trauma, with loss of nasal bonetissue To compensate for the tissue loss an inert gel was applied as filling material After 10days the patient manifested local inflammatory reaction pain rhinitis sinusitis, mucous nasaldischarge and otalgia He was treated with prednisone 10 mg/d, clavulanic amoxicillin 500mg/ 8 h for 10 days with no clinical improvement The patient received multiple treatmentswith antibiotics and antiinflammatories for 6 months with deformation of the nasal regionrespiratory distress and gradual health deterioration In the absence of a favorable evolutionsurgical resection of all the filling material and nasal mucosa was performedRESULTSThe obtained material was grown in media for common germs and fungi withnegative results Histopathology with H&E there was little inflammatory reaction and thepresence of globose ascoma 65 105 μ m diameter brown ascospores compatible withChaetomium sensu lato was observed Treatment was initiated with itraconazole 200 mg/ 24 h,with remission of signs and symptoms after 20 days No growth of the fungus was obtained inthe culture however we describe for the first time ascomas compatible with Chaetomium spin the nasal mucosa of a patient with favorable resolution of the disease after surgicalresection and antifungal treatmentCONCLUSIONSAlthough recovery of the microorganism in the culture is the gold standard forthe identification of the causative agent, histopathology was the tool that allowed us to arrive

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