Invasive Infections Caused byTrichosporonSpecies andGeotrichum capitatumin Patients with Hematological Malignancies: a Retrospective Multicenter Study from Italy and Review of the Literature

Abstract

Trichosporonosis is an uncommon but frequently fatal mycosis in immunocompromised patients 8 and 91.7%, respectively). Well over half of these were suffering from acute leukemia (68 and 84% of patients with Trichosporon sp. and G. capitatum infections, respectively). Crude mortality rates were 77% for Trichosporon spp. and 55.7% for G. capitatum. The optimal therapy for trichosporonosis has yet to be identified; however, in vitro experiences are providing encouraging evidence of the potential role of the new triazoles, in particular, voriconazole.

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

“…Colonization in those sites sometimes leads to secondary localizations via hematogenous dissemination mainly in the lung and liver (4,6). Invasive G. capitatum infection is relatively rare, approximately 100 cases having been reported (1,3,4,7,8). Risk factors for systemic G. capitatum infection have been reported to be prolonged neutropenia, intensive chemotherapy, the use of broad-spectrum antibacterial agents and local disruption of skin and mucosal defenses (2, 9-11).…”

“…capitatum infection is an uncommon fungal infection, especially in Japan. This filamentous fungus is found in soil, and frequently isolated from human skin, respiratory and digestive tracts (1). Colonization in those sites sometimes leads to secondary localizations via hematogenous dissemination mainly in the lung and liver (4,6).…”

“…Despite intensive antifungal therapy, the mortality rate is approximately 50-75% (1,2). The emergence of G. capitatum has been noted predominantly in European countries, particularly in Mediterranean areas (1). Here, we report a Japanese case of systemic G. capitatum infection in a severely neutropenic patient with acute myelogeneous leukemia with multilineage dysplasias.…”

“…G. capitatum, formerly known as Trichosporon capitatum or Brastochizomyces capitatus, is an anamorph of Dipodascus capitatus, so that Dipodascus capitatus is a taxonomic teleomorph of G. capitatum (5). Despite intensive antifungal therapy, the mortality rate is approximately 50-75% (1,2). The emergence of G. capitatum has been noted predominantly in European countries, particularly in Mediterranean areas (1).…”

“…Invasive systemic Geotrichum capitatum (G. capitatum) infection is rare, and has been reported exclusively in immunocompromised patients, particularly those receiving intensive chemotherapies for hematological malignancies such as acute leukemia (1)(2)(3)(4). G. capitatum, formerly known as Trichosporon capitatum or Brastochizomyces capitatus, is an anamorph of Dipodascus capitatus, so that Dipodascus capitatus is a taxonomic teleomorph of G. capitatum (5).…”