Micafungin-breakthrough Coniochaeta hoffmannii (Lecythophora hoffmannii) fungemia following cord blood transplant in a patient with acute myeloid leukemia successfully treated with voriconazole.

Autor: Shinohara K; Department of Laboratory Medicine, Graduate School of Medicine and Faculty of Medicine Kyoto University, Kyoto, Japan. Electronic address: shinoharakoh@kuhp.kyoto-u.ac.jp., Itoi S; Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan., Nakamura S; Department of Microbiology, Tokyo Medical University, Tokyo, Japan., Miyazaki Y; Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan., Mutoh Y; Department of Infectious Diseases, Tosei General Hospital, Aichi, Japan., Hagiwara S; Department of Hematology, Mito Kyodo Hospital, Ibaraki, Japan., Ohmagari N; Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy [J Infect Chemother] 2024 Sep; Vol. 30 (9), pp. 934-937. Date of Electronic Publication: 2024 Feb 17.
DOI: 10.1016/j.jiac.2024.02.011
Abstrakt: Phaeohyphomycosis is caused by dematiaceous (pigmented) fungi. Most phaeohyphomycosis is non-invasive infections, however, they can lead to invasive infections, including fungemia and disseminated disease, particularly in severely immunocompromised patients. Invasive phaeohyphomycosis has recently emerged, however, the treatment strategy was not determined because of the intrinsic resistance to antifungals and the lack of clinical experience. Here, we describe a novel case of echinocandin-breakthrough Coniochaeta hoffmannii (Lecythophora hoffmannii) fungemia after hematopoietic stem cell transplantation, which was identified using matrix-assisted laser desorption ionization time-of-flight mass spectrometry and ribosomal RNA sequencing. The patient was a female in her 40s who had acute myeloid leukemia refractory to chemotherapy before progressing to cord blood transplantation. Before developing fungemia, the patient was administered multiple broad-spectrum antibiotics and micafungin for recurrent infections and prophylaxis. Clinical and microbiological responses to liposomal amphotericin B were poor but improved after replacement to voriconazole and engraftment. A literature review of the previously reported cases with C. hoffmannii human infections imply that disruption of the cutaneous/mucosal barrier and the use of antimicrobial agents, both antibiotics and antifungals, could incite C. hoffmannii invasive infections.
Competing Interests: Declaration of Competing interest All authors declare no conflicts of interest associated with this manuscript.
(Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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