Disseminated Geotrichosis in Prolonged Neutropenia

[摘要] Background: Disseminated fungemia due to non-candida yeast is emerging as an opportunistic infection in hematological malignancies with prolonged neutropenia. Invasive infections by Geotrichum spp. are extremely rare and constitute only about 1% of all non-candida yeasts. The mortality in such patients is high and is seldom reported in the literature. Case Report: Here we describe a middle-aged man with treatment-resistant Hodgkin's lymphoma who developed invasive Geotrichum capitatus infection during his neutropenic phase, with poor response to combination therapy with voriconazole and amphotericin B. Conclusion: Geotrichum capitatus is responsible for fatal fungemia in patients with prolonged neutropenia complicating hematological malignancies. Geotrichum species are considered intrinsically resistant to echinocandins. Fluconazole minimum inhibitory concentration (MIC) for this species remains high. A high index of suspicion is required in this patient-group to identify disseminated geotrichosis as delay in treatment worsens mortality. We recommend the use of voriconazole with amphotericin B in immunocompromised patients with a high risk of disseminated fungemia.

[学科分类] 生理学

[关键词] Amphotericin B;Candida;Fungemia;Geotrichosis;Neutropenia;Voriconazole.