Blastoschizomyces capitatus infection in patients with leukemia: report of 26 cases.
Twenty-six cases of Blastoschizomyces capitatus infection were diagnosed in 25 patients at 7 tertiary care hematology units in Spain over a 10-year period. Most patients (92%) had acute leukemia and developed infection during a period of severe and prolonged neutropenia. Two patients had esophagitis, and the rest had invasive infection. Fungemia (20 cases) was a common finding, with frequent visceral dissemination. The 30-day mortality associated with this infection was 52%, compared with 57% among patients with systemic infection. In a univariate analysis, the following 3 variables had a positive impact on 30-day survival: removal of the central venous catheter within 5 days after the onset of infection (P=.02), a good performance status (P=.003), and receipt of systemic prophylactic or empirical antifungal therapy before infection onset (P=.006). Outcome for neutropenic patients with B. capitatus infection is still poor. Rapid removal of the central venous catheter and novel antifungal therapies are recommended for treatment of this rare infection.
Martino
Rodrigo
R
Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. rmartino@hsp.santpau.es
Salavert
Miguel
M
Parody
Rocío
R
Tomás
José F
JF
de la Cámara
Rafael
R
Vázquez
Lourdes
L
Jarque
Isidro
I
Prieto
Elena
E
Sastre
José Luis
JL
Gadea
Ignacio
I
Pemán
Javier
J
Sierra
Jorge
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy*; D009894:Opportunistic Infections / Q000188:drug therapy* / Q000382:microbiology; D012189:Retrospective Studies; D004718:Saccharomycetales / Q000187:drug effects; D016896:Treatment Outcome
D000935:Antifungal Agents