Infecciones invasivas debidas a Saprochaete capitata en pacientes con neoplasias hematológicas: informe de cinco casos y revisión del tratamiento antimicótico / Invasive infections caused by Saprochaete capitata in patients with haematological malignancies: report of five cases and review of the antifungal therapy

Background. Saprochaete capitata (formerly known as Geotrichum capitatum and Blastoschizomyces capitatus) is a ubiquitous fungus found in soil, water, air, plants and dairy products. It colonizes the skin, and bronchial and intestinal tract of healthy people producing serious opportunistic infections in patients with haematological malignancies, especially in those with acute leukaemia. Since 1960s its presence is being increasingly recognized in this group of patients. The clinical spectrum of S. capitata disseminated infections is very similar to that produced by Candida, being easily misinterpreted. The associated high mortality and low susceptibility to fluconazole and echinocandins of S. capitata require the acknowledgement of this emergent infection so that it can be properly treated. Case report. We report 5 new cases of S. capitata disseminated infection in patients with advanced haematological malignancies observed in the haematology unit between the years 2004 and 2010, and review the state-of-the-art for diagnosis and treatment of this infection. Conclusions. Based on our experience, the prophylactic use of or the empirical antifungal treatment with fluconazole and/or echinocandins would not be adequate for oncohaematological patients in those hospitals where S. capitata infection may be highly prevalent (AU)

Case of fatal Blastoschizomyces capitatus infection occurring in a patient receiving empiric micafungin therapy.

We report the first case, to our knowledge, of Blastoschizomyces capitatus infection occurring in a patient receiving empirical echinocandin therapy for neutropenic fevers. Clinicians should consider B. capitatus infection in those neutropenic patients who remain febrile despite echinocandin therapy or who develop yeast bloodstream infections while receiving an echinocandin.

Fungal contamination of food in hematology units.

The prevalence of thermotolerant fungi on non-heat-sterilizable food was determined. Aspergillus spp. were noted in 100% of pepper and regular tea samples, 12 to 66% of fruits, 27% of herbal teas, and 20% of freeze-dried soup samples. All soft cheese samples were contaminated by Geotrichum and yeast (Candida norvegensis) but Candida albicans was never identified.

Influence of sundrying on the chemical composition, aflatoxin content and fungal counts of two pepper varieties--Capsicum annum and Capsicum frutescens.

Samples of sundried, matured red pepper, Capsicum annum with a moisture content (MC) of 12.7-26.8 percent had on dry weight basis, vitamin C, 5.0-6.4 mg/100 g; crude protein, 0.8-1.2 percent; total soluble solids, 3.3-4.1 percent, and fungal counts of log 4.4-4.5/g. Ordinary matured red C. annum had MC, 75.7-78.2 percent vitamin C, 36.1-38.5 mg/100 g; crude protein, 2.4-2.8 percent; total soluble solids, 9.3-9.9 percent and fungal count of log 3.32-3.39/g. Sundried matured red C. frutescens had corresponding values of 9.4-18.7 percent; 5.8-6.3 mg/100 g; 0.8-1.1 percent; 0.9-2.6 percent and log 3.2-3.4/g. No aflatoxins were detected in sundried, matured red C. frutescens, but aflatoxin B1 values obtained from C. annum varied from non-detectable to 2.2 micrograms/kg. Dominant fungi isolated from C. annum and C. frutescens were Rhizopus oryzaze, Aspergillus niger, A. flavus, Geotrichum candidum and Saccharomyces spp.

Recent research on the etiology of esophageal cancer in China.

China could be expected to offer good opportunities for the investigation of esophageal cancer since it has both high and low incidence areas. However, it seems impossible to attribute the induction of esophageal cancer to one particular substance--it rather seems to be caused by a variety of factors. To the authors' opinion, esophageal cancer may originate from exposure to N-nitroso compounds or mycotoxins. Lack of certain trace elements or essential vitamins may also play a role. Contrary to France, which also has high incidence areas of esophageal cancer, excessive alcohol consumption is of no importance in China. It is not clear whether genetic factors can be discussed.