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Hernández Solis A, Rabadan Armenta SJ, Araiza Santibáñez J, Bonifaz A, Serna Valle FJ, Mojica Jaimes E. Necrotizing pneumonia due to Saprochaete capitata in a patient with diabetes mellitus. Case report. Med Mycol Case Rep 2023; 42:100603. [PMID: 37701416 PMCID: PMC10494254 DOI: 10.1016/j.mmcr.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/08/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Abstract
Saprochaete capitata is a yeast-like fungus of the Dipodascaceae family, capable of colonizing the skin and the respiratory and gastrointestinal tracts. We present a 56-year-old man with diabetes mellitus who was admitted to the hospital presenting with fever, cough and hemoptysis. The diagnosis of necrotizing pneumonia was made by direct microscopy of the bronchoalveolar lavage fluid showed and Saprochaete capitata was identified by Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight (MALDI-TOF MS®). Treatment consisted of itraconazole 200 mg every 12 hours orally for 30 days, leading to clinical and radiological improvement. Saprochaete capitata infection is a rare cause of pulmonary mycoses.
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Affiliation(s)
- Alejandro Hernández Solis
- Servicio de Neumología y Cirugía de Tórax, Hospital General de México, “Dr. Eduardo Liceaga”, Ciudad de México, Código postal: 06720, Mexico
| | - Saul Javier Rabadan Armenta
- Servicio de Neumología y Cirugía de Tórax, Hospital General de México, “Dr. Eduardo Liceaga”, Ciudad de México, Código postal: 06720, Mexico
| | - Javier Araiza Santibáñez
- Laboratorio de Micología, Hospital General de México, “Dr. Eduardo Liceaga”, Ciudad de México, Código postal: 06720, Mexico
| | - Alexandro Bonifaz
- Laboratorio de Micología, Hospital General de México, “Dr. Eduardo Liceaga”, Ciudad de México, Código postal: 06720, Mexico
| | | | - Eliasib Mojica Jaimes
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Estado de México. Código postal: 54075, Mexico
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El Zein S, Hindy JR, Kanj SS. Invasive Saprochaete Infections: An Emerging Threat to Immunocompromised Patients. Pathogens 2020; 9:pathogens9110922. [PMID: 33171713 PMCID: PMC7694990 DOI: 10.3390/pathogens9110922] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/16/2022] Open
Abstract
Saprochaete clavata and Saprochaete capitata are emerging fungal pathogens that are responsible for life threatening infections in immunocompromised patients, particularly in the setting of profound neutropenia. They have been associated with multiple hospital outbreaks mainly in Europe. In this article, we present a comprehensive review of the epidemiology, clinical presentation, diagnosis, antifungal susceptibility and treatment of these organisms. The diagnosis of invasive Saprochaete disease is challenging and relies primarily on the isolation of the fungi from blood or tissue samples. Both species are frequently misidentified as they are identical macroscopically and microscopically. Internal transcribed spacer sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry are useful tools for the differentiation of these fungi to a species level. Saprochaete spp. are intrinsically resistant to echinocandins and highly resistant to fluconazole. Current literature suggests the use of an amphotericin B formulation with or without flucytosine for the initial treatment of these infections. Treatment with extended spectrum azoles might be promising based on in vitro minimum inhibitory concentration values and results from case reports and case series. Source control and recovery of the immune system are crucial for successful therapy.
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Affiliation(s)
- Said El Zein
- Internal Medicine Department, Wayne State University/Detroit Medical Center, Detroit, MI 48201, USA;
| | - Joya-Rita Hindy
- Division of Infectious Diseases, Internal Medicine Department, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon;
| | - Souha S. Kanj
- Division of Infectious Diseases, Internal Medicine Department, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon;
- Correspondence:
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Pavone P, Oliva A, Raponi G, Pugliese F, Martelli S, Celli P, Sacco F, Vullo V, Mastroianni CM, Russo G. Disseminated fungal infection due to Saprochaete clavata in a kidney transplant recipient. J Mycol Med 2019; 29:278-281. [PMID: 31202517 DOI: 10.1016/j.mycmed.2019.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/24/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
Saprochaete clavata and Saprochaete capitata are closely related fungal species (family Dipodascaceae, order Saccharomycetales) that are rarely involved in the etiology of systemic infections in humans. In recent years, these yeasts are emerging as cause of life-threatening infections in patients with severe neutropenia and haematological malignancies. Infections by these fungi have been reported mostly from Mediterranean countries. To the best of our knowledge, only 2 cases of infection due to S. capitata have been reported in solid organ transplant recipients and none due to S. clavata. Herein we report a fatal case of S. clavata disseminated infection occurring in a patient with recent kidney transplantation and severe neutropenia. Patient was receiving antifungal echinocandin prophylaxis and the yeast was isolated from the blood and multiple non contiguous sites. Saprochaete spp. should be considered in the differential diagnosis of invasive mycoses in transplant recipients, especially if they are neutropenic and living or travelling in Mediterranean countries.
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Affiliation(s)
- P Pavone
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy.
| | - A Oliva
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
| | - G Raponi
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
| | - F Pugliese
- Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Sapienza University of Rome, Rome, Italy
| | - S Martelli
- Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Sapienza University of Rome, Rome, Italy
| | - P Celli
- Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Sapienza University of Rome, Rome, Italy
| | - F Sacco
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
| | - V Vullo
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
| | - C M Mastroianni
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
| | - G Russo
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
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Hajar Z, Medawar W, Rizk N. Saprochaete capitata (Geotrichum capitatum), an emerging fungal infection in kidney transplant recipients. J Mycol Med 2018; 28:387-389. [PMID: 29709266 DOI: 10.1016/j.mycmed.2018.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 11/30/2022]
Abstract
We are reporting the case of an 82-year-old Yemeni patient, renal transplant recipient who was admitted to our institution and who subsequently developed disseminated infection with Saprochaete capitata. This pathogenic fungus is rarely reported in patients with solid organ trans-plants. Saprochaete capitata is an emerging fungal pathogen, ubiquitously spread in the environment. This is the second case to our knowledge of infection with Saprochaete capitata in a renal transplant patient. Our patient was treated for multiple nosocomial infections with prolonged antibiotic courses. He succumbed to the infection with Saprochaete capitate after several weeks spent in the intensive care unit.
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Affiliation(s)
- Z Hajar
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - W Medawar
- Department of Internal Medicine, Division of Nephrology, American University of Beirut Medical Center, Beirut, Lebanon
| | - N Rizk
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon.
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Bansal N, Devarajan V, Ghafur K A, Sethuraman N, Sree V L. Breakthrough Saprochaete Capitata infections among patients with hematological malignancies. Leuk Lymphoma 2017; 59:1762-1763. [PMID: 29214882 DOI: 10.1080/10428194.2017.1402306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Nitin Bansal
- a Department of Infectious Diseases , Apollo Speciality Hospital , Chennai , India
| | - Vidya Devarajan
- a Department of Infectious Diseases , Apollo Speciality Hospital , Chennai , India
| | - Abdul Ghafur K
- a Department of Infectious Diseases , Apollo Speciality Hospital , Chennai , India
| | | | - Lakshmi Sree V
- b Department of Microbiology , Apollo Speciality Hospital , Chennai
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Pamidimukkala U, Kancharla A, Sudhaharan S, Gundeti S, Mandarapu S, Nagalla VK, Raju SB, Karanam SD. Isolation of the Rare Opportunistic Yeast Saprochaete capitata from Clinical Samples-Experience from a Tertiary Care Hospital in Southern India and a Brief Review of the Literature. J Clin Diagn Res 2017; 11:DC36-DC42. [PMID: 29207709 DOI: 10.7860/jcdr/2017/30339.10669] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/23/2017] [Indexed: 11/24/2022]
Abstract
Introduction Saprochaete capitata (Teleomorph: Magnusiomyces capitatus) is a ubiquitous yeast found in environmental sources such as soil, water, air, plants and dairy products. It is also a part of the normal microbial flora in humans. The yeast is being increasingly reported as an opportunistic pathogen, especially in patients in the haemato-oncology setting, the infection being often mistakenly diagnosed as invasive candidiasis. Aim To review the epidemiological, clinical and microbiological features of six patients admitted in our hospital over a period of 10 years (from January 2007 to December 2016), from whom Saprochaete capitata was isolated. Materials and Methods A retrospective study was conducted and the epidemiological, clinical, imaging and microbiological data of the six patients were collected and analysed. Results The age of the six patients ranged from 19 years to 65 years with a median age of 53 years. There were two males and four females. In three out of the six patients, the isolation of S. capitata was considered clinically significant as the yeast was isolated repeatedly from blood and/or respiratory specimens and the clinical features could not be explained by any other alternative diagnosis. Haematological malignancy was the underlying disease in three out of the six patients while one patient was on triple immunosuppression following renal transplantation four years back. Three out of the six patients had severe neutropenia with Absolute Neutrophil Count (ANC) ≤ 500 at the time of isolation of S. capitata. Two patients with clinical features of fungal sepsis received antifungal therapy with Amphotericin B but succumbed within a short period of starting the therapy. The post renal transplant patient who presented with pneumonia recovered after treatment with a combination of Amphotericin B and Voriconazole. Conclusion Awareness regarding the epidemiological, clinical and microbiological aspects of invasive infections caused by S. capitata is essential for early recognition and appropriate management.
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Affiliation(s)
- Umabala Pamidimukkala
- Associate Professor, Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telengana, India
| | - Anuradha Kancharla
- Consultant, Department of Microbiology, Asian Institute of Gastroenterology, Hyderabad, Telengana, India
| | - Sukanya Sudhaharan
- Assistant Professor, Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telengana, India
| | - Sadashivudu Gundeti
- Associate Professor, Department of Medical Oncology, Nizam's Institute of Medical Sciences, Hyderabad, Telengana, India
| | - Surendra Mandarapu
- Senior Resident, Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telengana, India
| | - Vamsi Krishna Nagalla
- Senior Resident, Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telengana, India
| | - Sree Bhushan Raju
- Professor and Head, Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telengana, India
| | - Sandhya Devi Karanam
- Laboratory Technician, Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telengana, India
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