Magnusiomyces clavatus infection in a child after allogeneic hematotopoetic stem cell transplantation: Diagnostic and therapeutic implications

Abstract

Magnusiomyces clavatus is an ascomycetous fungus causing invasive disease in immuno-compromised patients. Neutropenia, contaminated venous catheters, previous antifungal treatment are risk factors for this infection. We report a case of Magnusiomyces clavatus fungemia with pulmonary, renal and skin localizations in a 6-year-old boy with prolonged neutropenia because of three allogeneic hematopoietic stem cell transplantations. The infection was controlled by aggressive and strictly monitored combination therapy with voriconazole and liposomial-ampthotericine-B along with durable recover from neutropenia.

Saprochaete clavata Invasive Infections – A New Threat to Hematological-Oncological Patients

“…Voriconazole and liposomal amphotericin B have provided mixed successes. Adding flucytosine to those drugs as suggested by Lacroix’s report and supported in vitro data could represent a potentially useful therapeutic modality for both (Tables 2–4) (Lacroix et al, 2007; Picard et al, 2014; Favre et al, 2016; Leoni et al, 2018; Liu et al, 2018). There are limited data about the therapeutic usefulness of posaconazole and isavuconazole (Miceli and Kauffman, 2015; Brunetti et al, 2016).…”

“…S. clavata is almost exclusively confined to systemic, life-threatening infections while the clinical presentation of infections caused by other arthroconidial fungi range from superficial ( Trichosporon spp. ), mucosal ( Galactomyces candidus ), allergic ( Trichosporon pneumonitis) to systemic forms ( T. asahii, M. capitatus , and G. candidus ) (Girmenia et al, 2005; Henrich et al, 2009; Bonifaz et al, 2010; Vaux et al, 2014; de Almeida Júnior and Hennequin, 2016; Durán Graeff et al, 2017; Esposto et al, 2018; Leoni et al, 2018; Salgüero Fernández et al, 2018). AML is the leading underlying condition for systemic infections caused by S. clavata such as for other arthroconidial yeasts (Girmenia et al, 2005; Henrich et al, 2009; Camus et al, 2014; de Almeida Júnior and Hennequin, 2016).…”

“…That can suggest influence of some unknown epidemiological factor(s). All arthroconidial fungi are ubiquitous in nature but Trichosporon infections are more frequently described in the United States, while M. capitatus prevails in the Mediterranean area (Italy, France, Spain, Turkey, Greece, Tunisia, Israel, Libya, FungiScope ® ) (Schiemann et al, 1998; Gadea et al, 2004; Christakis et al, 2005; Girmenia et al, 2005; García-Ruiz et al, 2013; Vaux et al, 2014; Trabelsi et al, 2015; Del Principe et al, 2016; Durán Graeff et al, 2017; Esposto et al, 2018; Leoni et al, 2018; Salgüero Fernández et al, 2018). We found no correlation between temperature in the Czechia and in Eastern Bohemia and the number of isolated S. clavata strains during the follow-up period (data not shown).…”

“…Most systemic infections caused by those arthroconidial fungi are attributable to two species, Magnusiomyces capitatus (synonym Saprochaete capitata ) and Trichosporon asahii . Saprochaete clavata has emerged as a new pathogen in hematological patients in French and Italian hospitals (Lacroix et al, 2007; Camus et al, 2014; Picard et al, 2014; Vaux et al, 2014; Cornely et al, 2015; Del Principe et al, 2016; Favre et al, 2016; Esposto et al, 2018; Leoni et al, 2018). Taxonomy studies showed that S. clavata and M. capitatus are closely related (de Hoog et al, 1986; Guého et al, 1987; Smith and Poot, 1998).…”

Saprochaete clavata (Geotrichum clavatum) septicemia in a patient with multiple myeloma; An emerging case from Southeastern Turkey

“…Previous case reports have indicated that S. clavata was resistant to echinocandins and sensitive to voriconazole in [ 2 , 5 , 8 , 10 , 12 ]. In addition, voriconazole and/or liposomal amphotericin B treatments were reported as the most successful ones [ 8 , 9 , 14 , 20 ]. In the current report, S. clavata infection developed while the patient was receiving fluconazole treatment.…”