Pseudocanariomyces americanus, gen. nov., sp. nov., A New Thielavia-Like Species in the Chaetomiaceae: Identification and Management of a Prosthetic Hip Infection

This report describes the phenotypic characteristics of a novel fungal species, isolated from a prosthetic hip infection. The patient, who had undergone multiple total hip arthroplasties due to Legg-Calvé-Perthes disease, presented with continued fever and wound dehiscence. Findings upon incision and draining were notable for necrotic tissue and a sinus tract from the fluid collection. Intraoperative cultures were positive for a sterile filamentous fungus. BLASTn results following DNA sequencing placed the isolate within the family Chaetomiaceae close to the genera Madurella, Canariomyces, Stolonocarpus, Stellatospora, Ovatospora, Carteria and Melanocarpus. Phylogenetic analysis demonstrated that the isolate was a new thielavia-like species, Pseudocanariomyces americanus. Antifungal susceptibility was performed, and low minimum inhibitory concentrations were observed with amphotericin B, itraconazole, posaconazole, and voriconazole. The patient was initially treated with voriconazole but was switched to posaconazole secondary to a photosensitivity reaction. Acceptable posaconazole trough concentrations were achieved, and the patient remained stable without pain or drainage from her surgical incision.