| Autor: |
Ortiz-Álvarez J; Laboratorio de Biología Molecular de Bacterias y Levaduras, Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas Instituto Politécnico Nacional, Plan de Ayala y Prolongación Carpio, Santo Tomas, Mexico City 11340, Mexico., Reséndiz-Sánchez J; Hospital Infantil de México, Federico Gómez (HIMFG), Doctor Márquez 162, Doctores, Mexico City 06720, Mexico., Juárez-Montiel M; Laboratorio de Biología Molecular de Bacterias y Levaduras, Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas Instituto Politécnico Nacional, Plan de Ayala y Prolongación Carpio, Santo Tomas, Mexico City 11340, Mexico., Hernández-García JA; Laboratorio de Biología Molecular de Bacterias y Levaduras, Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas Instituto Politécnico Nacional, Plan de Ayala y Prolongación Carpio, Santo Tomas, Mexico City 11340, Mexico., Vázquez-Guerrero E; Laboratorio de Genética Microbiana, Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas Instituto Politécnico Nacional, Plan de Ayala y Prolongación Carpio, Santo Tomas, Mexico City 11340, Mexico., Hernández-Rodríguez C; Laboratorio de Biología Molecular de Bacterias y Levaduras, Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas Instituto Politécnico Nacional, Plan de Ayala y Prolongación Carpio, Santo Tomas, Mexico City 11340, Mexico., Villa-Tanaca L; Laboratorio de Biología Molecular de Bacterias y Levaduras, Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas Instituto Politécnico Nacional, Plan de Ayala y Prolongación Carpio, Santo Tomas, Mexico City 11340, Mexico. |
| Abstrakt: |
Magnusiomyces capitatus (also denominated “Geotrichum capitatum” and “the teleomorph stage of Saprochaete capitata”) mainly affects immunocompromised patients with hematological malignancies in rare cases of invasive fungal infections (IFIs). Few cases have been reported for pediatric patients with acute lymphoblastic leukemia (ALL), in part because conventional diagnostic methods do not consistently detect M. capitatus in infections. The current contribution describes a systemic infection in a 15-year-old female diagnosed with ALL. She arrived at the Children’s Hospital of Mexico City with a fever and neutropenia and developed symptoms of septic shock 4 days later. M. capitatus ENCB-HI-834, the causal agent, was isolated from the patient’s blood, urine, bile, and peritoneal fluid samples. It was identified with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and a phylogenetic reconstruction using internal transcribed spacer (ITS) and 28S ribosomal sequences. The phylogenetic sequence of M. capitatus ENCB-HI-834 clustered with other M. capitatus-type strains with a 100% identity. In vitro antifungal testing, conducted with the Sensititre YeastOne susceptibility system, found the following minimum inhibitory concentration (MIC) values (μg/mL): posaconazole 0.25, amphotericin B 1.0, fluconazole > 8.0, itraconazole 0.25, ketoconazole 0.5, 5-flucytosine ≤ 0.06, voriconazole 0.25, and caspofungin > 16.0. No clinical breakpoints have been defined for M. capitatus. This is the first clinical case reported in Mexico of an IFI caused by M. capitatus in a pediatric patient with ALL. It emphasizes the importance of close monitoring for a timely and accurate diagnosis of neutropenia-related IFIs to determine the proper treatment with antibiotics, antifungals, and chemotherapy for instance including children with ALL. |
