Successful Treatment of Systemic Geotrichum capitatum Infection by Liposomal Amphotericin-B, Itraconazole, and Voriconazole in a Japanese Man

Ikuta, Katsuya; Torimoto, Yoshihiro; Yamamoto, Masayo; Okamura, Naoka; Hosoki, Takaaki; Sato, Kazuya; Fujiya, Mikihiro; Kohgo, Yutaka

doi:10.2169/internalmedicine.49.3887

Cited by 23 publications

(15 citation statements)

References 18 publications

(25 reference statements)

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“…M. capitatus a été isolé dans notre cas dans le sang, les urines, et le LBA comme dans les cas décrits par Birrenbach et al [3] et Purohit et al [26]. Dans d'autres observations, l'isolement s'est fait soit uniquement à partir du sang [4,6,9,14,15,20], soit à partir du sang et des expectorations [13,27], soit des urines [3,21], soit du liquide de dialyse [3].…”

Section: Discussionunclassified

“…Les résultats des CMI ont montré une bonne sensibilité au voriconazole, à l'amphotéricine B et à la 5FC. Les échinocandines (caspofungine, micafungine) en traitement empirique ou en prophylaxie ont été utilisées dans d'autres cas [4,6,20,26]. Garcia-Ruiz et al [16] ont rapporté 5 cas d'infection disséminée à Saprochaete capitata, un anamorphe de M. capitatus précédemment connu sous le nom de G. capitatum ou de Blastoschizomyces capitatum [1,10] chez des patients atteints de tumeurs malignes hématologiques.…”

Section: Discussionunclassified

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Infection fongique disséminée à Magnusiomyces capitatus chez un patient transplanté hépatique

Yapo-Kouadio

Hasseine

Goubaux

et al. 2016

Journal de Mycologie Médicale / Journal of Medical Mycology

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Section: Discussionunclassified

Infection fongique disséminée à Magnusiomyces capitatus chez un patient transplanté hépatique

Yapo-Kouadio

Hasseine

Goubaux

et al. 2016

Journal de Mycologie Médicale / Journal of Medical Mycology

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“…19 Although there is no clinical evidence to support a recommendation for using combination therapy for S clavata, several case reports have described successful outcomes with combination liposomal amphotericin B and voriconazole. 5,20,21 Herein, we report a monocentric outbreak of four cases of severe S clavata infection without an identifiable common source in a haematology unit in Northern Italy that occurred over a threemonth period. We also review key diagnostic, microbiological and treatment issues for this rare but aggressive infection.…”

Section: Introductionmentioning

confidence: 98%

“…Voriconazole, itraconazole, posaconazole, amphotericin B and 5‐fluorocytosine have more predictable potency in vitro and in vivo, while higher MICs have been reported for fluconazole and isavuconazole . Although there is no clinical evidence to support a recommendation for using combination therapy for S clavata , several case reports have described successful outcomes with combination liposomal amphotericin B and voriconazole …”

Section: Introductionmentioning

confidence: 99%

Saprochaete clavata infections in patients undergoing treatment for haematological malignancies: A report of a monocentric outbreak and review of the literature

Stanzani

Cricca

Sassi

et al. 2019

Mycoses

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Summary Saprochaete clavata is a rare cause of fungaemia with deep organ involvement in patients with haematological malignancies with reported mortality rates of 60%‐80%. We describe four cases of S clavata infection in a haematology unit over several months that were treated with voriconazole‐based regimens. We also review the literature on factors that could contribute to earlier recognition and effective treatment of S clavata. We included all cases of culture‐positive S clavata from sterile sites with associated signs of infection in patients undergoing treatment for a haematological malignancy. Isolates were identified by MALDI‐TOF MS, and spectrum profiles were used to prepare clustering analysis of isolates. Susceptibility testing was performed using a commercial microtitre methods. Saprochaete clavata was isolated from the bloodstream in three cases and bronchial alveolar lavage (BAL) fluid in one case. Clustering analysis suggested strains of S clavata were clonal without evidence of divergence although a common source was not identified. Susceptibility testing yielded elevated MICs to fluconazole (8 mg/L) and echinocandins (>1‐8 mg/L). All patients were treated with voriconazole‐based regimens resulting in survival of 3/4 patients, who continued chemotherapy for their underlying malignancy without evidence of relapse. Saprochaete clavata is a rare but aggressive cause of breakthrough yeast infection in patients undergoing treatment for haematological malignancies, particularly patients with a prior history of echinocandin treatment. Timely initiation of appropriate treatment, aided by more rapid identification in microbiology laboratory, can reduce the risk of deep organ dissemination and patient death.

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“…The therapeutic options against these infections are limited, because S. capitata is considered intrinsically resistant to the echinocandins (7)(8)(9)(10). Currently, there are no recommendations for the management of infections caused by S. capitata, although amphotericin B is the drug most commonly used in the clinical setting, followed by itraconazole and voriconazole (9,(11)(12)(13)(14). The use of these compounds is supported by the in vitro antifungal susceptibility of S. capitata to such drugs.…”

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confidence: 99%

Efficacy of Posaconazole in a Murine Model of Systemic Infection by Saprochaete capitata

Thomson

Guarro

Mayayo

et al. 2015

Antimicrob Agents Chemother

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The fungus Saprochaete capitata causes opportunistic human infections, mainly in immunocompromised patients with hematological malignancies. The best therapy for this severe infection is still unknown. We evaluated the in vitro killing activity and the in vivo efficacy of posaconazole at 5, 10, or 20 mg/kg twice a day (BID) in a murine neutropenic model of systemic infection with S. capitata by testing a set of six clinical isolates. Posaconazole showed fungistatic activity against all of the isolates tested. The different doses of the drug, especially the highest one, showed good efficacy, measured by prolonged survival, reduction of (1-3)-␤-D-glucan levels in serum, tissue burden reduction, and histopathology. Saprochaete capitata, formerly known as Trichosporom capitatum, Geotrichum capitatum, and Blastoschizomyces capitatus, is an uncommon clinical fungus belonging to the phylum Basidiomycota, but it is able to cause fatal fungemia in immunocompromised patients, especially in those with hematological malignancies (1-6). The therapeutic options against these infections are limited, because S. capitata is considered intrinsically resistant to the echinocandins (7-10). Currently, there are no recommendations for the management of infections caused by S. capitata, although amphotericin B is the drug most commonly used in the clinical setting, followed by itraconazole and voriconazole (9,(11)(12)(13)(14). The use of these compounds is supported by the in vitro antifungal susceptibility of S. capitata to such drugs. However, despite treatment, the mortality rate still remains high, at around 60% (5, 15-19), making it necessary to explore new therapeutic approaches. In previous studies conducted on mice, high doses of fluconazole demonstrated higher efficacy than amphotericin B, flucytosine, and voriconazole (20). Posaconazole has not been evaluated against this fungal species before but has shown efficacy in experimental infections against a wide range of opportunistic fungi, such as Aspergillus spp., Curvularia spp., Rhizopus oryzae (21,22,23), and others, including Trichosporon asahii, which is taxonomically related to S. capitata (24). In the present study, we evaluated the in vitro killing activity of posaconazole against this fungus as well as its in vivo efficacy in a neutropenic murine model of systemic infection by S. capitata. (IHEM 5665, IHEM 5666, IHEM 5091, IHEM 6803, IHEM 16105, and IHEM 16109) were included in this study. The inocula were prepared from potato dextrose agar (PDA) cultures by flooding the plates with 3 ml of sterile saline solution and scraping the surface of the colonies with a loop in order to obtain a conidial suspension. To remove hyphal fragments and clumps of agar, the resulting suspension was filtered twice through sterile gauze and then adjusted by hemocytometer counts to the desired concentrations. Viability of inocula was determined by placing 10-fold dilutions of the conidial suspension on PDA plates. MATERIALS AND METHODS Strains and inocula. Six clinical strains of S. ca...

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Successful Treatment of Systemic Geotrichum capitatum Infection by Liposomal Amphotericin-B, Itraconazole, and Voriconazole in a Japanese Man

Cited by 23 publications

References 18 publications

Infection fongique disséminée à Magnusiomyces capitatus chez un patient transplanté hépatique

Infection fongique disséminée à Magnusiomyces capitatus chez un patient transplanté hépatique

Saprochaete clavata infections in patients undergoing treatment for haematological malignancies: A report of a monocentric outbreak and review of the literature

Efficacy of Posaconazole in a Murine Model of Systemic Infection by Saprochaete capitata

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