Pulmonary Infection due to Trametes elegans and Peniophora incarnata

Recent environmental changes and advances in modern medicine—particularly the increasing use of immunosuppressive therapies and organ transplantation—have led to a growing number of infections caused by fungi that were previously not recognized as human pathogens. We report a case of pulmonary infection caused by Trametes elegans and Peniophora incarnata in a 27-year-old man with advanced acquired immunodeficiency syndrome who presented with multiple bilateral pulmonary nodules. Both fungi, which are rare environmental homobasidiomycetes, were identified using molecular methods. Thermal tolerance was demonstrated by Trametes elegans, supporting its ability to proliferate in human lungs, while Peniophora incarnata showed limited growth at 35 ℃. Initial treatment with liposomal amphotericin B was ineffective; however, the patient’s condition improved following a switch to voriconazole. Climate change may increase the incidence of such opportunistic infections in individuals with compromised immunity.