N SOYER, F. VURAL, A DÖNMEZ, S BİÇEROĞLU, M TOMBULOĞLU, S ÇAĞIRGAN

Hepatosplenic Geotrichum capitatum infection in a patient with acute promyelocytic leukemia

Geotrichum capitatum, immün yetmezliği olan hastalarda nadir görülen invaziv oportunistik bir infeksiyondur. Akut promyelositik lösemi seyrinde hepatosplenik Geotrichum capitatum infeksiyonu gelişen bir olguyu sunmaktayız. Hastanın lösemi tedavisi sırasında alkalin fosfataz artışı ve antibiyotik tedavisine dirençli ateşi gelişti. Batın ultrasonografisi ve bilgisayarlı tomografisinde karaciğer ve dalakta çok sayıda fokal lezyonların varlığı ve kan kültüründe G. capitatum saptanması ile hastaya hepatosplenik kandidiasis tanısı kondu. Liposomal amphoterisin B ile hasta başarıyla tedavi edildi.

Akut promyelositik lösemili bir hastada hepatosplenik Geotrichum capitatum enfeksiyonu

Geotrichum capitatum infection is a rare, opportunistic fungus which causes invasive disease in immunocompromised patients. We report a case of hepatosplenic infection with Geotrichum capitatum in a patient with acute promyelocytic leukemia. After chemotherapy, the patient developed fever unresponsive to antibiotic treatment, elevated serum alkaline phosphatase. Blood cultures revealed a G. capitatum infection and ultrasound and abdominal computed tomography showed multiple focal lesions in the liver and spleen. We treated the patient successfully with amphotericin B.

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1. Martino P, Venditti M, Micozzi A, et al. Blastoschizomyces capitatus: An emerging cause of invasive fungal disease in leukemia patients. Rev Infect Dis 1990; 12: 570-582.

2. Bouza E and Munoz P. Invasive infections caused by Blastoschizomyces capitatus and Scedosporium spp. Clin Microbiol Infect 2004; 10(Suppl.1): 76-85.

3. Christakis G, Perlorentzou S, Aslanidou M, et al. Fatal Blastoschizomyces capitatus sepsis in a neutropenic patient with acute myeloid leukemia:first documented case from Greece. Mycoses 2005; 48: 216-220.

4. Perez-Sanchez I, Anguita J, Martin-Rabadan P et al. Blastoschizomyces capitatus infection in acute leukemia patients. Leukemia Lymphoma 2000 ; 391:209-212.

5. Mahul p, piens MA, Guyotat D, et al. Disseminated Geotrichum capitatum infection in a patient with acute myeloid leukaemia. Mycoses 1989; 32: 573-577.

6. Cofrancesco E, Viviani MA, Boschetti C, et al. Treatment of chronic disseminated Geotrichum capitatum infection with high cumulative dose of colloidal amphotericin B and itraconazole in a leukaemia patient. Mycoses 1995; 38: 377-384.

7. Amft N, Miadonna A, Viviani MA, Tedeschi A. Disseminated Geotrichum capitatum infection with predominant liver involvement in a patient with non Hodgkin’s lymphoma. Haematologica 1996; 81: 352-355.

8. Martino R, Salavert M, Parody R, et al. Blastoschizomyces capitatus infection in patients with leukemia: Report of 26 cases. Clin Infect Dis 2004; 38: 335-341.

9. Groll AH, Walsh TJ. Uncommon opportunistic fungi: new nosocomial threats. Clin Microbiol Infect 2001; 7 (Suppl.2): 8-24.

10. Buchta V, Zak P, Kohout A, Otcenasek M. Disseminated infection of Blastoschizomyces capitatus in a patient with acute myelocytic leukaemia. Mycoses 2001; 44: 505-512.

11. DeMaio J, Colman L. The use of adjuvant interferon-gamma therapy for hepatosplenic Blastoschizomyces capitatus infection in a patient with leukemia. Clin Infect Dis 2000; 31: 822-824.

12. Fianchi L, Montini L, Caira M, et al. Combined voriconazole plus caspofungin therapy for the treatment of probable Geotrichum pneumonia in a leukemia patient. Infection 2008; 36: 65-67.

13. Centers for Disease Control and Prevention; Infectious Disease Society of America; American Society of Blood and Marrow Transplantation. Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. MMWR Recomm Rep 2000 ; 49(RR-10): 1-125, CE1-7.