TY - JOUR
T1 - A cluster of Geotrichum clavatum (Saprochaete clavata) infection in haematological patients: a first Italian report and review of literature
AU - Del Principe, Maria Ilaria
AU - Sarmati, Loredana
AU - Cefalo, Mariagiovanna
AU - Fontana, Carla
AU - De Santis, Giovanna
AU - Buccisano, Francesco
AU - Maurillo, Luca
AU - De Bellis, Eleonora
AU - Postorino, Massimiliano
AU - Sconocchia, Giuseppe
AU - Del Poeta, Giovanni
AU - Sanguinetti, Maurizio
AU - Amadori, Sergio
AU - Pagano, Livio
AU - Venditti, Adriano
PY - 2016
Y1 - 2016
N2 - nvasive 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.
AB - nvasive 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.
KW - (1→3)-β-d-glucan
KW - Geotrichum clavatum
KW - acute myeloid leukaemia
KW - emerging yeast infections
KW - fungaemia
KW - liposomal amphotericin-B
KW - susceptibility tests
KW - (1→3)-β-d-glucan
KW - Geotrichum clavatum
KW - acute myeloid leukaemia
KW - emerging yeast infections
KW - fungaemia
KW - liposomal amphotericin-B
KW - susceptibility tests
UR - http://hdl.handle.net/10807/84167
U2 - 10.1111/myc.12508
DO - 10.1111/myc.12508
M3 - Article
SN - 0933-7407
VL - 59
SP - 594
EP - 601
JO - Mycoses
JF - Mycoses
ER -