Septic shock induced by Lecythophora mutabilis in a patient with mitochondrial encephalomyopathy

Abstract

Invasive fungal infection (IFI) caused by Lecythophora mutabilis occasionally occurs in patients with impaired host immunity; such patients had eosinophilia at onset, and surviving patients were treated with fungal cell-membrane-targeted drugs. An 18-year-old man with mitochondrial encephalomyopathy accompanied with refractory anaemia and chronic renal failure developed septic shock caused by L. mutabilis, which was detected from a blood culture, and was identified morphologically and genetically. During the course of the infection, he had eosinophilia, although b-D-glucan levels were within the normal range. He was treated with micafungin, but deteriorated and died, despite his treatment being changed to liposomal amphotericin B. On the basis of this we suggest that IFI caused by L. mutabilis should be suspected when a compromised host develops infection and eosinophilia, and that antifungal drugs that target b-D-glucan are not advisable.

Molecular and Phenotypic Characterization of Phialemonium and Lecythophora Isolates from Clinical Samples

“…The number of clinical cases reporting infections by Lecythophora is even lower. Cases are caused by either L. hoffmannii or L. mutabilis (2,7,8,16,21,22,28). In our study, the above-mentioned two Phialemonium species and two Lecythophora species were also the predominant species identified.…”

“…Lecythophora hoffmannii has been associated with cases of subcutaneous infections, keratitis, sinusitis, peritonitis, and canine osteomyelitis (16,21). Lecythophora mutabilis has been described to be the causative agent of human peritonitis, endocarditis, endophthalmitis, and keratitis, among others (2,7,8,22,28).…”

<I>Coniochaeta</I> (<I>Lecythophora</I>), <I>Collophora</I> gen. nov. and <I>Phaeomoniella</I> species associated with wood necroses of <I>Prunus</I> trees

“…Some species such as Lecythophora hoffmannii (teleomorph: Coniochaeta ligniaria ) and L. mutabilis are also known as human pathogens involved in keratitis, subcutanous abscesses, peritonitis, endocarditis and septic shock (de Hoog et al 2000, Drees et al 2007, Taniguchi et al 2009). They have also been isolated from food, e.g., butter (Samson et al 2004).…”

The mycobiome of Australian tree hollows in relation to the Cryptococcus gattii and C. neoformans species complexes

“…The choice of another target, more discriminatory between the C. gattii and C. neoformans species complexes, such as the entire ITS region or the URA5 gene (Meyer et al, 2003) (Damm, Fourie, & Crous, 2010;de Hoog, Guarro, Gené, & Figueras, 2000;Khan et al, 2013;Taniguchi et al, 2009). There is some speculation that yeasts may be overrepresented in NGS analyses due to their higher nucleus to cytoplasm ratio when compared to filamentous fungal species with longer cells (Lindahl et al, 2013).…”

“…Three genera: Coniochaeta, Aspergillus, and Penicillium, dominated the mycobiome. Species in the Coniochaeta genus (pleomorphic yeasts) are known pathogens of trees and are often isolated from necrotic wood samples but can also cause opportunistic human infections after traumatic implantation, such as keratitis, subcutaneous abscesses, peritonitis, and endocarditis (Damm, Fourie, & Crous, 2010;de Hoog, Guarro, Gené, & Figueras, 2000;Khan et al, 2013;Taniguchi et al, 2009). There is some speculation that yeasts may be overrepresented in NGS analyses due to their higher nucleus to cytoplasm ratio when compared to filamentous fungal species with longer cells (Lindahl et al, 2013).…”