Epidemiology and outcome of systemic infections due to saprochaete capitata: case report and review of the literature

Abstract

A case of systemic infection due to Saprochaete capitata in a patient with chronic lymphocytic leukemia is described. A review of the literature was conducted to identify all reported cases of this infection described between 1977 and August 2013. One hundred and four cases (included the present one) were identified. The median age of the patients was 56 years and 56% were males. Comorbidities included acute myeloid leukemia (52%), acute lymphoid leukemia (22%), other hematological malignancies (13%) and non-hematological diseases (9%). At the time of the infection, 82% of the patients were neutropenic. In 75% of the cases, the yeast was isolated from blood culture, in 25% from other sterile sites. Empirical treatment was done in 36% of the cases. Fifty-eight percent of the individual cases were treated with a combination or a sequential antifungal therapy. Amphotericin B was the antifungal drug most commonly used, followed by voriconazole and itraconazole. The overall crude mortality was 60%. Saprochaete capitata causes life-threatening infections in neutropenic patients. This comprehensive literature review may help the clinician to optimize the management of this rare infection.

Disseminated Saprochaete capitata in a patient with Diabetes mellitus and HCV Hepatitis; A Case Report

“…She met her demise suffering from multiorgans dysfunction and failure. Here, Saprochaete capitata isolate was resistant to the tested antifungals, this agrees with the previously published literature from different authors that disseminated infection with Saprochaete capitata is usually difficult to treat and carries high mortality [2,7,8]. This is one of the rare cases of disseminated Saprochaete capitata in a patient without hematological malignancy; however the patient had a prolonged ICU stay, mechanical ventilation, and was exposed to several antibacterials, which are known risk factors for acquiring invasive candidiasis [10,11].…”

“…The majority of patients (82%) were neutropenic at the time of diagnosis, and 75% of Saprochaete capitatawere isolated from blood. Mortality was about 60% and amphotericin was the mostly prescribed antifungal [2]. After their report, two cases were reported by other investigators as well as our current case [5,7].…”

“…It can also be found in the digestive tract in humans and other mammals, and it may be found in food but never reported to cause disease through this route. The number of recorded Saprochaete capitata cases in English literature and related species so far are around 104 cases [1,2]. Disseminated Saprochaete capitata was reported in few case reports of single and five-case series, causing blood stream infection with severe sepsis syndrome, multi-organ failure, and mortality.…”

Rol de la cirugía en el manejo de la infección invasora por Saprochaete capitata

“…Candida y Aspergillus spp siguen siendo los patógenos más frecuentemente aislados, sin embargo, es de importancia conocer la emergencia de nuevos patógenos. Saprochaete capitata en pacientes inmunocompetentes puede causar infecciones leves como onicomicosis, no obstante, en pacientes con neutropenias severas puede causar infecciones sistémicas graves, caracterizadas por su alta tasa de mortalidad, que alcanza cifras de hasta 60% [7][8][9][10] . Saprochaete capitata (Teleomorfo: Magnusiomyces capitatus, previamente Geotrichum capitatum, Trichosporon capitatum, Dipodascus capitatus o Blastoschizomyces capitatus) es una levadura ascomicética, no fermentadora, no capsulada, ureasa negativa, que habita el suelo, agua, aire y plantas 11 .…”

“…El primer caso de micosis invasora por S. capitata publicado data de 1960 y revisiones de la literatura han identificado 104 casos reportados entre 1977 y 2013 1,10 . De acuerdo a la información obtenida, la patología más frecuentemente asociada (52%) es la LMA, seguida de la leucemia linfoide aguda (22%) y otras patologías hematológicas malignas (13%) 10 . Además, en 82% de los casos el paciente se encuentra neutropénico 10 .…”