Speakers - 2026

Title: Pulmonary verruconis infection in an immunocompetent patient: A case report and literature review

Abstract

Verruconis gallopava (V. gallopava) is a thermophilic, darkly pigmented fungus commonly found in hot environments. Despite its environmental ubiquity, fewer than fifty human infections have been reported. While it primarily affects immunocompromised individuals, only six cases in immunocompetent patients have  been documented, representing a diagnostically challenging subset. We describe a case of pulmonary V. gallopava infection in a 75-year-old immunocompetent woman. Despite broad-spectrum antibiotics and antifungal treatments, including liposomal amphotericin B and voriconazole, the patient's condition deteriorated. Bronchoalveolar lavage (BAL) revealed hyphal forms, and fungal culture identified Verruconis species. Antifungal susceptibility tests showed low minimal inhibitory concentrations (MICs) for amphotericin B (1 μg/mL) and voriconazole (0.5 μg/mL). Clinical manifestations of immunocompetent pneumonia patients lack specificity. We identify structural lung disease as a risk factor in immunocompetent hosts. BAL fungal culture and metagenomics for rare fungi is helpful in rare fungal diagnosis. Treatment regimens vary, with amphotericin B and triazoles being the most frequently used antifungal agents. Both diagnosis and treatment are not standard. Further studies are needed to establish protocols for diagnosis and treatment.