Blastoschizomyces capitatuspulmonary infections in immunocompetent patients: case report, case series and literature review

Abstract

Blastoschizomyces capitatus is an uncommon opportunistic yeast associated with infections in neutropaenic patients secondary to haematological malignancies, with a special predilection for the lungs. Globalisation and population migration impact on the epidemiology of infection with this organism but its effect on the immunocompetent population has rarely been described. We present here a case report, an overview of 11 other cases published between 2000 and 2016, and a comprehensive literature review of Blastoschizomyces pneumonia in the non-immunocompromised. The median age at diagnosis was 68 years (range 40-86 years) and more than half the cases reported a positive history of either current or past tobacco smoking. Six cases had either clinical or radiological evidence of chronic obstructive pulmonary disease and three had a history of prior treated tuberculosis. Fluconazole and itraconazole, alone or in combination, was the most utilised treatment. We conclude that unlike most other invasive yeast species, B. capitatus poses an infectious risk for immunocompetent patients, usually of middle to older age with risk factors for distorted lung architecture. Further research is warranted into the pathophysiology of Blastoschizomyces infections in the immunocompetent, including standardised treatment options.

A case of Saprochaete capitata pulmonary infection in a neutropenic HIV-infected patient

“…The present case of S. capitata pneumonia in a former tuberculous lung adds to the few reports in the literature [5, 15, 18, 20]. Even in immunocompetent individuals, TB impairs the lung structure, making it a breeding ground for opportunistic infections such as geotrichosis, as described in the three cases reported by Tanabe et al .…”

“…S. capitata is thermotolerant (up to 45 °C), resistant to cycloheximide, and unable to assimilate a large number of carbohydrates (except glucose and galactose) or hydrolyse urea, which helps distinguish it from Trichosporon spp. [5,15]. Morphologically, Saprochaete species are identical.…”

Saprochaete Capitata Infection in an 80–Year Old Chronic Obstructive Pulmonary Disease (COPD) Patient: A Case Report

“…The pneumonia in S. capitata usually associated in haematological malignancies or multiple diseases. It could make the infection becomes more severse [15].…”

All You Need To Know and More about the Diagnosis and Management of Rare Yeast Infections

“…Patients with fungemia often present with hepatosplenic abscesses, metastatic skin lesion, brain abscesses, or osteomyelitis ( 37 – 39 ). However, these yeasts also cause disease in immunocompetent individuals ( 40 ). Trichosporon asahii is the major etiological agent of invasive trichosporonosis ( 5 ).…”