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Kamran Khan and Sameed Qureshi
Acremonium is rare fungal specie that causes mycetoma, mycotic keratitis and onychomycosis, and it may cause disseminated infection in immunocompromised patients. Herein, we report a 17-year-old immuno competent male diagnosed with invasive gastrointestinal acremonium infection. He presented to us with fever and abdominal pain with marked eosinophilia. Radiological scans revealed multiple hepatic lesions and thickening of the gut wall. He previously had a biopsy done which reported necrotizing granulomatous inflammation with septate hyphae and he was put on voriconazole for eight months. The patient underwent exploratory laparotomy for his continuous abdominal and biopsy of the resected mass showed the same necroinflammatory changes with septate hyphae. Subsequent culture of the biopsy specimens yielded Acremonium cephalosporium specie. He was subsequently resumed on voriconazole and the patient showed marked clinical improvement. This is a first case in the literature of acremonium infection presented with gastrointestinal dissemination.