Kavitha SELVAN, Gökhan MUTLU

SARS-CoV-2 enfeksiyonlu bağışıklığı sağlam bir hastada Geotrichum enfeksiyonu

COVID-19 ile ilişkili sekonder bakteriyel ve fungal enfeksiyonlara ilişkin raporlar gün geçtikçe artmaktadır. Aspergillus spp. ve Candida spp. ile enfeksiyonların, olguların tarif edildiği ilk raporlarının ardından Mucorales spp. ile enfeksiyonlarda önemli bir artış olmuştur. Bu olgu sunumunda COVID-19 olan bağışıklığı sağlam bir hastada Geotrichum spp.’ye bağlı enfeksiyonu bildiriyoruz. Bildiğimiz kadarıyla, bu COVID-19’daki ilk Geotrichum enfeksiyonu vakasıdır. Geotrichum, bağışıklığı baskılanmış ve özellikle nötropenili hastalarda ortaya çıkan, geotrikoz olarak adlandırılan invaziv hastalığa neden olan, nadir ortaya çıkan bir patojendir. SARS-CoV-2 enfeksiyonlu hastalarda Geotrichum gibi invaziv mantar enfeksiyonu gelişimi, yüksek derecede klinik şüphe gerektirir ve özellikle altta yatan bir bağışıklık sistemi baskılanmış durumu olanlarda ve kortikosteroidler veya diğer bağışıklık bastırıcı ajanlar alan hastalarda düşünülmelidir.

Geotrichum infection in an immunocompetent host with SARS-CoV-2 infection

There has been increasing reports of secondary bacterial and fungal infections associated with COVID-19. Following the initial reports of infection with Aspergillus spp., and Candida spp. there has been a significant rise in infections with Mucorales spp. In this case report, we present a case of Geotrichum spp. infection in an immunocompetent host with COVID-19. To our knowledge, this is the first case of Geotrichum infection in COVID-19. Geotrichum is a rare emerging pathogen that causes invasive disease, termed geotrichosis, which occurs in immunocompromised adult hosts with neutropenia. The development of invasive fungal infection such as Geotrichum in patients with SARS-CoV-2 infection requires a high degree of clinical suspicion and should be considered particularly in those who have an underlying immunocompromised state and those receiving corticosteroids or other immunosuppressive agents.

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1. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-13.
2. Marr KA, Platt A, Tornheim JA, Zhang SX, Datta K, Cardozo C, Garcia-Vidal C. Aspergillosis Complicating Severe Coronavirus Disease. Emerging infectious diseases 2021; 27.
3. Raut A, Huy NT. Rising incidence of mucormycosis in patients with COVID-19: another challenge for India amidst the second wave? Lancet Respir Med 2021.
4. John TM, Jacob CN, Kontoyiannis DP. When Uncontrolled Diabetes Mellitus and Severe COVID-19 Converge: The Perfect Storm for Mucormycosis. J Fungi (Basel) 2021; 7.
5. Witting C, Quaggin-Smith J, Mylvaganam R, Peigh G, Angarone M, Flaherty JD. Invasive pulmonary aspergillosis after treatment with tocilizumab in a patient with COVID- 19 ARDS: a case report. Diagn Microbiol Infect Dis 2021; 99: 115272.
6. Burger BJ, Epps SM, Cardenas VM, Jagana R, Meena NK, Atchley WT. Tocilizumab is associated with increased risk of fungal infections among critically ill patients with COVID-19 and acute renal failure: an observational cohort study. Research Square 2021.
7. Kimmig LM, Wu D, Gold M, Pettit NN, Pitrak D, Mueller J, et al. IL-6 Inhibition in Critically Ill COVID-19 Patients Is Associated With Increased Secondary Infections. Front Med (Lausanne) 2020; 7: 583897.
8. Sheehy TW, Honeycutt BK, Spencer JT. Geotrichum septicemia. JAMA 1976; 235: 1035-7.
9. Duran Graeff L, Seidel D, Vehreschild MJ, Hamprecht A, Kindo A, Racil Z, et al. Invasive infections due to Saprochaete and Geotrichum species: Report of 23 cases from the FungiScope Registry. Mycoses 2017; 60: 273-9.
10. Winer-Muram HT. Geotrichosis: who is susceptible? Chest 1988; 94: 1315-6.
11. Radic M, Goic Barisic I, Kuscevic D, Novak A, Tonkic M, Rubic Z. Geotrichum capitatum respiratory tract infection in a patient with polytrauma. Infez Med 2015; 23: 270-4.
12. Hrdy DB, Nassar NN, Rinaldi MG. Traumatic joint infection due to Geotrichum candidum. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 1995; 20: 468-9.
13. Keene S, Sarao MS, McDonald PJ, Veltman J. Cutaneous geotrichosis due to Geotrichum candidum in a burn patient. Access Microbiol 2019; 1: e000001.
14. Bilman FB, Yetik M. Geotrichum candidum: A Rare Infection Agent in Urinary System: Case Report and Review of The Literature. J Clin Exp Invest 2017; 8: 127-9.
15. Sfakianakis A, Krasagakis K, Stefanidou M, Maraki S, Koutsopoulos A, Kofteridis D, et al. Invasive cutaneous infection with Geotrichum candidum: sequential treatment with amphotericin B and voriconazole. Med Mycol 2007; 45: 81-84.
16. Bonifaz A, Vazquez-Gonzalez D, Macias B, Paredes- Farrera F, Hernandez MA, Araiza J, et al. Oral geotrichosis: report of 12 cases. J Oral Sci 2010; 52: 477-83.
17. Zuo T, Zhang F, Lui GCY, Yeoh YK, Li AYL, Zhan H, et al. Alterations in Gut Microbiota of Patients With COVID-19 During Time of Hospitalization. Gastroenterology 2020; 159: 944-55.
18. Zuo T, Zhan H, Zhang F, Liu Q, Tso EYK, Lui GCY, et al. Alterations in Fecal Fungal Microbiome of Patients With COVID-19 During Time of Hospitalization until Discharge. Gastroenterology 2020; 159: 1302-10.