Neosartorya fischeri: an invasive fungal pathogen in an allogeneic bone marrow transplant patient

Abstract

Summary:The patient underwent allogeneic BMT in February 1995 from a 5/6 HLA-matched sister. The conditioning regimen consisted of thiotepa 5 mg/kg, CY 60 mg/kg/day × 2 and Invasive fungal infections are a complication of allogeneic BMT. We report the first case of a Neosartorya fractionated TBI to a total dose of 1200 cGy. The transplanted marrow was depleted selectively of T lymphocytes fischeri fungal infection in a patient following allogeneic BMT. Neosartorya fischeri is related to Aspergillus fumiby incubation of a Ficoll preparation of the donor bone marrow on anti-CD5 and anti-CD8 antibody coated plates gatus, but it is a distinct fungal species. Despite granulocytic engraftment and aggressive anti-fungal therapy (Cellector, AIS, Santa Clara, CA, USA). GVHD prophylaxis consisted of MTX, CsA, and methylprednisolone. The with amphotericin B, the patient died of overwhelming fungal infection on day 60 post-BMT. Neosartorya fispatient received antimicrobial prophylaxis with minocycline, norfloxacin and fluconazole. The hospital course was cheri is a pathogen that grows slowly in culture which can delay or confuse identification. This case further complicated by Streptococcus sanguis bacteremia requiring treatment with i.v. vancomycin on day 5 post-BMT. The supports the need for more effective prophylaxis and treatment of non-Candida fungal infections in the allogpatient achieved an absolute neutrophil count of 500 cells/ l on day 20 post-BMT, but was still platelet-transeneic BMT population. Keywords: Neosartorya fischeri; infection; bone marfusion dependent. On day 28, multiple small dark purpuric skin lesions row transplantation were noted on the arms, shoulders and trunk ranging in size from 0.3 to 1 cm in diameter. Within 1 to 2 days, the lesions developed central necrosis. Skin biopsy revealed fungal Case report organisms and biopsy cultures grew an unidentified fungal organism in the on-site laboratory. The fluconazole was A 48-year-old male presented in September 1994 with stopped, and the patient was started on amphotericin B at fever, anemia, thrombocytopenia, and a white blood cell a dose of 1 mg/kg daily. An attempt was made to taper count of 145 000 per l. The bone marrow aspirate demonthe methylprednislone which resulted in a flare of GVHD strated 100% cellularity with 90% blasts that were PAS manifested by a stage 2 skin and stage 2 liver involvement positive and Sudan Black negative, most consistent with to an overall grade of 3. Steroids were increased to 1 L2 acute lymphoblastic leukemia. However, by flow cytomg/kg/day resulting in stage 1 skin and liver disease. On metry, the leukemia cells were positive for CD19, CD34, day 33 the patient developed slurred speech and had a focal CD13, and CD38 antigens and negative for cell surface right-sided seizure. Lumbar puncture was negative and a immunoglobulin, consistent with an undifferentiated leukehead magnetic resonance imaging (MRI) demonstrated left mia. Cytogenetic analysis demonstrated a 2q:4q reciprocal temporal edema with no enhancement. ...

Clinical Significance and Molecular Characterization of Nonsporulating Molds Isolated from the Respiratory Tracts of Bronchopulmonary Mycosis Patients with Special Reference to Basidiomycetes

“…In addition, 2 patients had pneumonia due to N. fischeri. Previously, N. fischeri was reported for a solitary case of invasive fungal infection in a recipient of an allogeneic bone marrow transplant (35). As N. fischeri grows slowly in culture and fails to sporulate in routine media, the relevance of this pathogen in clinical contexts could be undetermined (35).…”

DNA Sequence Characterization and Molecular Evolution of MAT1 and MAT2 Mating-Type Loci of the Self-Compatible Ascomycete Mold Neosartorya fischeri

“…A. fumigatus is the most common cause of invasive aspergillosis infection in humans (8,22) and is only known to reproduce by asexual means involving the production of masses of mitotic conidiospores. N. fischeri has also been documented as an invasive opportunistic pathogen (4,24). However, unlike A. fumigatus, N. fischeri has a known sexual cycle and thus may reproduce by both asexual and sexual means (14,26).…”

Dermatitis Caused by Neosartorya hiratsukae Infection in a Hedgehog

“…While species of the genus Neosartorya present ubiquitously, they have only rarely been reported to be pathogenic. To date, only eight cases of Neosartorya infections in humans have been reported in the medical literature (2,5,8,10,12,14,19). N. hiratsukae was first described in Japan, where it was isolated from air and pasteurized aloe juice (20).…”