Asunto(s)
Humanos , Masculino , Niño , Adulto Joven , Geotricosis/complicaciones , Enfermedades Pulmonares Fúngicas/complicaciones , Enfermedad Granulomatosa Crónica/complicaciones , Geotricosis/diagnóstico por imagen , Enfermedades Pulmonares Fúngicas/diagnóstico por imagen , Enfermedad Granulomatosa Crónica/diagnóstico por imagenRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Fungemia/microbiología , Geotricosis/microbiología , Resultado Fatal , Geotricosis/complicaciones , Geotricosis/diagnósticoRESUMEN
Invasive fungal infections, usually Aspergillus and Candida, represent a major cause of morbidity and mortality in patients with malignant haematological diseases, but in the last years rare fungal infections have more frequently been reported. Here, we report the clinical history of three patients affected with haematological malignancies who developed an infection caused by Geotrichum (G.) clavatum. Two out of three patients were affected by acute myeloid leukaemia (AML), and one by mantle cell lymphoma (MCL). All patients received cytarabine-based chemotherapeutic regimens and developed G. clavatum infection within 3 weeks from therapy initiation. In all cases, G. clavatum was isolated from central venous catheter and peripheral blood cultures. In vitro susceptibility test confirmed an intrinsic resistance to echinocandins and, in all cases, visceral localisations (spleen, liver and lung) were documented by total body computed tomography (CT) scan. A prolonged antifungal therapy with high doses liposomal amphotericin-B was necessary to obtain fever resolution. Only the patient with MCL died while the other two AML recovered, and one of them after received an allogeneic stem cell transplantation. We consecutively reviewed all published cases of infection caused by G. clavatum. Our experience and literature review indicate that G. clavatum can cause invasive infection in haematological patients, mainly in those with acute leukaemia.
Asunto(s)
Geotricosis/complicaciones , Neoplasias Hematológicas/complicaciones , Infecciones Fúngicas Invasoras/complicaciones , Adulto , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Catéteres Venosos Centrales/microbiología , Farmacorresistencia Fúngica , Equinocandinas/uso terapéutico , Resultado Fatal , Femenino , Geotricosis/sangre , Geotricosis/epidemiología , Geotricosis/microbiología , Geotrichum/efectos de los fármacos , Neoplasias Hematológicas/epidemiología , Trasplante de Células Madre Hematopoyéticas , Humanos , Infecciones Fúngicas Invasoras/diagnóstico por imagen , Infecciones Fúngicas Invasoras/epidemiología , Infecciones Fúngicas Invasoras/microbiología , Italia , Leucemia Mieloide Aguda/complicaciones , Leucemia Mieloide Aguda/tratamiento farmacológico , Leucemia Mieloide Aguda/microbiología , Hígado/diagnóstico por imagen , Hígado/microbiología , Pulmón/diagnóstico por imagen , Pulmón/microbiología , Linfoma de Células del Manto/complicaciones , Linfoma de Células del Manto/tratamiento farmacológico , Linfoma de Células del Manto/microbiología , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Bazo/diagnóstico por imagen , Bazo/microbiología , Tomografía Computarizada por Rayos X , Adulto JovenAsunto(s)
Geotricosis/complicaciones , Geotrichum , Leucemia Mieloide Aguda/complicaciones , Infecciones Oportunistas/complicaciones , Anciano , Resultado Fatal , Femenino , Geotricosis/diagnóstico , Geotricosis/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/tratamiento farmacológicoRESUMEN
Geotrichum capitatum, formerly known as Trichosporon capitatum, is an uncommon but frequently fatal invasive fungal infection in immunocompromised patients, especially in hematological malignancies. We report a seven-year-old patient with acute myeloid leukemia with Geotrichum septicemia with involvement of the lungs, liver, spleen, and kidneys, who had a favorable outcome after therapy. Alteration of antifungal treatment to liposomal amphotericin B resolved the fever with favorable clinical response.
Asunto(s)
Geotricosis/microbiología , Geotrichum/aislamiento & purificación , Huésped Inmunocomprometido , Leucemia Mieloide Aguda/inmunología , Mananos/inmunología , Sepsis/microbiología , Niño , Galactosa/análogos & derivados , Geotricosis/complicaciones , Geotricosis/inmunología , Humanos , Leucemia Mieloide Aguda/complicaciones , Masculino , Sepsis/complicaciones , Sepsis/inmunologíaRESUMEN
We report a rare case of a fatal Saprochaete capitata breakthrough infection in a patient with acute myeloid leukemia receiving empirical caspofungin therapy. S. capitata is an uncommon, yet emerging cause of invasive infections, especially in patients with haematological malignancies. Blood cultures from our patient yielded S. capitata which was found to be resistant, in vitro, to caspofungin. We consecutively reviewed all published cases of breakthrough infections caused by S. capitata in patients receiving echinocandins. S. capitata should be considered in those patients who remain febrile or who develop invasive mould infections while under echinocandin therapy.
Asunto(s)
Antifúngicos/uso terapéutico , Equinocandinas/uso terapéutico , Geotricosis/tratamiento farmacológico , Geotrichum/aislamiento & purificación , Leucemia Mieloide Aguda/microbiología , Anciano , Caspofungina , Niño , Resultado Fatal , Femenino , Geotricosis/complicaciones , Geotrichum/patogenicidad , Humanos , Leucemia Mieloide Aguda/complicaciones , Lipopéptidos , Masculino , Persona de Mediana Edad , Pirimidinas/uso terapéutico , Triazoles/uso terapéutico , VoriconazolRESUMEN
Oral geotrichosis is an uncommon opportunistic infection caused by Geotrichum candidum, a habitual contaminant and component of the flora of various parts of the body. This communication reports both a 20-year retrospective study of clinically and mycologically proven cases of oral geotrichosis, and a prospective study of fungal oral flora in 200 individuals divided into two groups: normal individuals and individuals with associated conditions. Twelve patients with proven oral geotrichosis were included: 9 females and 3 males, with a mean age of 48.5 years; the associated conditions were diabetes mellitus (66.6%), leukemia, Hodgkin's lymphoma and HIV/AIDS infection. The oral geotrichoses showed three clinical varieties: pseudomembranous (75%), hyperplastic, and palatine ulcer. G. candidum was isolated in 11 cases and G. capitatum in one. Positive fungal cultures were obtained from the two groups, and 48% and 78% of cultures were positive, respectively, for Candida spp. In 2.8% and 6.33% of the cases, G. candidum was isolated, respectively, together with one strain of G. capitatum. Oral geotrichosis is an exceptional infection that clinically presents, and is treated, as oral candidiasis. G. candidum may be isolated from the oral flora of a small proportion of patients, either normal individuals or those with associated conditions.
Asunto(s)
Geotricosis/microbiología , Enfermedades de la Boca/microbiología , Infecciones Oportunistas/microbiología , Adulto , Anciano , Candidiasis Bucal/patología , Complicaciones de la Diabetes , Diagnóstico Diferencial , Femenino , Geotricosis/complicaciones , Geotricosis/patología , Infecciones por VIH/complicaciones , Humanos , Hifa/aislamiento & purificación , Huésped Inmunocomprometido , Leucemia/complicaciones , Linfoma/complicaciones , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/patología , Estudios RetrospectivosRESUMEN
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.
Asunto(s)
Antifúngicos/uso terapéutico , Equinocandinas/uso terapéutico , Geotricosis/complicaciones , Geotrichum/fisiología , Lipopéptidos/uso terapéutico , Neutropenia/complicaciones , Neutropenia/tratamiento farmacológico , Anciano , Resultado Fatal , Geotricosis/microbiología , Geotrichum/aislamiento & purificación , Humanos , Masculino , Micafungina , Pruebas de Sensibilidad MicrobianaRESUMEN
A rare case of an invasive cutaneous infection by Geotrichum candidum in an 80-year-old male patient with diabetes mellitus is reported. The primary site of infection manifested after trauma as an ulcerative lesion on the distal phalanx of the midfinger and extended throughout the right hand. Histological examination showed fungal invasion in the deep dermis without vascular involvement and G. candidum was grown in cultures from the biopsy material. Angiography revealed severe obstructive disease of the right brachial artery and its branches. Treatment, after susceptibility testing of the isolated strain, consisted of sequential administration of intravenous liposomal amphotericin B with oral voriconazole followed by liposomal amphotericin B, resulting in substantial improvement of the infection.
Asunto(s)
Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Geotricosis/tratamiento farmacológico , Geotricosis/microbiología , Geotrichum/aislamiento & purificación , Pirimidinas/uso terapéutico , Triazoles/uso terapéutico , Anciano de 80 o más Años , Diabetes Mellitus/microbiología , Geotricosis/complicaciones , Humanos , Masculino , VoriconazolRESUMEN
We report on a case of a 19-year-old female patient with acute promyelocytic leukemia suffering from febrile monarthitis of the right knee during neutropenia after consolidation chemotherapy caused by Geotrichum capitatum. Apparently this infection occurred due to a hematological reactivation since the patient had already developed Geotrichum capitatum fungemia during induction therapy. Under antimycotic therapy with voriconazole, flucytosine, and caspofungin as well as after two arthroscopic synovectomies with cleansing of the right knee, the infection could be controlled and the full clinical function of the knee joint could be preserved.
Asunto(s)
Antifúngicos/administración & dosificación , Artroplastia , Geotricosis/complicaciones , Geotricosis/terapia , Leucemia Promielocítica Aguda/complicaciones , Leucemia Promielocítica Aguda/terapia , Adulto , Femenino , Humanos , Articulación de la Rodilla/efectos de los fármacos , Articulación de la Rodilla/patología , Articulación de la Rodilla/cirugíaAsunto(s)
Geotricosis/complicaciones , Geotricosis/inmunología , Recurrencia Local de Neoplasia/complicaciones , Infecciones Oportunistas/complicaciones , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Animales , Resultado Fatal , Femenino , Geotricosis/microbiología , Humanos , Huésped Inmunocomprometido , Persona de Mediana Edad , Recurrencia Local de Neoplasia/microbiología , Leucemia-Linfoma Linfoblástico de Células Precursoras/microbiologíaRESUMEN
Blastoschizomyces capitatus (formerly known as Geotrichum capitatum and Trichosporon capitatum) is a rare, yet an emerging, cause of invasive infections in immunosuppressed patients. Profound and prolonged neutropenia is the crucial predisposing factor for this yeast infection. Blastoschizomyces capitatus was isolated from peripheral blood cultures of a profoundly neutropenic patient with acute myeloid leukemia (M2 FAB). Despite administration of antifungal chemotherapy with liposomal amphotericin B at 4.5 mg kg(-1) daily, the patient succumbed 4 days after initiation of treatment. Infections attributed to B. capitatus have generally a poor prognosis, although the yeast shows in vitro susceptibility to antifungal agents. Low flucytosine, caspofungin acetate, voriconazole and amphotericin B minimum inhibitory concentration values were also recorded with our isolate. The clinical relevance of the in vitro susceptibility testing against the isolate and the current antifungal chemotherapy regimens against B. capitatus systemic infections are discussed.
Asunto(s)
Geotricosis/microbiología , Geotrichum/aislamiento & purificación , Leucemia Mieloide Aguda/complicaciones , Neutropenia/complicaciones , Sepsis/microbiología , Anciano , Anfotericina B/administración & dosificación , Anfotericina B/farmacología , Anfotericina B/uso terapéutico , Antifúngicos/administración & dosificación , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Sangre/microbiología , Resultado Fatal , Fungemia , Geotricosis/complicaciones , Geotricosis/tratamiento farmacológico , Grecia , Humanos , Masculino , Sepsis/complicaciones , Sepsis/tratamiento farmacológicoRESUMEN
A 32 year old male, positive for human immunodeficiency virus (mY) antibodies, was found to be positive for multiple opportunistic infections by a parasite and a fungi, which is a very rare occurrence. Cryptosporidium and Geotrichum were simultaneously detected from his stool and sputum respectively.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA , Criptosporidiosis/complicaciones , Geotricosis/complicaciones , Infecciones por VIH/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Infecciones Oportunistas Relacionadas con el SIDA/parasitología , Adulto , Animales , Criptosporidiosis/microbiología , Cryptosporidium/aislamiento & purificación , Heces/microbiología , Heces/parasitología , Geotricosis/microbiología , Geotrichum/aislamiento & purificación , Humanos , Parasitosis Intestinales/complicaciones , Parasitosis Intestinales/parasitología , Enfermedades Pulmonares Fúngicas/complicaciones , Enfermedades Pulmonares Fúngicas/microbiología , Enfermedades Pulmonares Parasitarias/complicaciones , Enfermedades Pulmonares Parasitarias/parasitología , Masculino , Esputo/microbiología , Esputo/parasitologíaRESUMEN
Viral or fungal pneumonia generally occurs in immunocompromised patients. We report a case of hypoxic pneumonia unresponsive to broad-spectrum antibiotic therapy in a patient whose only risk factor for immunodeficiency was mild silent renal failure. The causal association between Herpes simplex and Geotrichum candidum was retained on the basis of endobronchial samples and the favorable course after institution of specific treatment. It is thus useful to consider these pathogens in patients with lung infection in order to institute specific treatment.
Asunto(s)
Geotricosis/complicaciones , Herpes Simple/complicaciones , Enfermedades Pulmonares Fúngicas/complicaciones , Neumonía Viral/complicaciones , Insuficiencia Renal/complicaciones , Anciano , Humanos , Masculino , Índice de Severidad de la EnfermedadAsunto(s)
Geotricosis/complicaciones , Infecciones por VIH/prevención & control , Proctitis/complicaciones , Inhibidores de la Transcriptasa Inversa/efectos adversos , Quimioterapia Combinada , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Lamivudine/administración & dosificación , Lamivudine/efectos adversos , Lamivudine/uso terapéutico , Persona de Mediana Edad , Inhibidores de la Transcriptasa Inversa/administración & dosificación , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Zidovudina/administración & dosificación , Zidovudina/efectos adversos , Zidovudina/uso terapéuticoRESUMEN
We report a case of systemic infection with Geotrichum capitatum in a patient with acute myeloid leukaemia. Three days before death, the patient developed acute renal failure, probably caused by occlusion of glomerula with hyphae of G. capitatum. Up until now, prophylaxis and treatment of infections caused by Geotrichum capitatum have not been established. However, the prophylactic administration of high-dose itraconazole and the therapeutic use of liposomal amphotericin B are subjects of discussion.
Asunto(s)
Fungemia/complicaciones , Geotricosis/complicaciones , Leucemia Mieloide/complicaciones , Neutropenia/complicaciones , Enfermedad Aguda , Lesión Renal Aguda , Sangre/microbiología , Fungemia/tratamiento farmacológico , Geotricosis/tratamiento farmacológico , Humanos , Glomérulos Renales/patología , Libia/etnología , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Persona de Mediana Edad , Radiografía , TomografíaRESUMEN
We studied 66 cases of intestinal mycosis and parasitosis in patients infected with the human immunodeficiency virus with chronic diarrhea. All subjects were from the Yaounde urban area and were followed between February and December 1996. They were recruited from 3 hospitals in the center of Yaounde and were aged between 2 and 52 years. There was weight loss in 80.3% and severe dehydration in 72.3% of cases. Feces consisted mostly of watery stools similar to those of cholera patients (50% of cases) and loose stools (43.9% of cases). Parasitic agents were detected in 31.8% and fungal agents in 80.5% of cases. The opportunistic Protozoans detected included Cryptosporidium parvum (15.8%), microsporidia (8.8%) and Isospora belli (3.5%). Six cases of helminthiasis were also identified. Candida albicans was the most common opportunistic mycosis agent (39.1%). Other fungal species detected included Geotrichum candidum, Candida pseudotropicalis and Trichosporon sp. but all of these were less common.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Diarrea/etiología , Huésped Inmunocomprometido , Parasitosis Intestinales/complicaciones , Micosis/complicaciones , Adolescente , Adulto , Animales , Camerún , Candidiasis/complicaciones , Niño , Preescolar , Enfermedad Crónica , Coccidiosis/complicaciones , Criptosporidiosis/complicaciones , Cryptosporidium parvum , Deshidratación/etiología , Diarrea/microbiología , Diarrea/parasitología , Heces , Femenino , Estudios de Seguimiento , Geotricosis/complicaciones , Humanos , Isospora , Masculino , Microsporida , Microsporidiosis/complicaciones , Persona de Mediana Edad , Salud Suburbana , Trichosporon , Salud Urbana , Pérdida de PesoRESUMEN
We describe the first known case of vertebral osteomyelitis and discitis caused by Blastoschizomyces capitatus in a leukemic patient and the results of therapy. We also reconfirm the microbiological characteristics which differentiate this species from other yeastlike pathogens.