Breakthrough invasive infection due to Debaryomyces hansenii (teleomorph Candida famata) and Scopulariopsis brevicaulis in a stem cell transplant patient receiving liposomal amphotericin B and caspofungin for suspected aspergillosis.
An allogeneic stem cell transplant recipient developed pulmonary infiltrates and Aspergillus antigenemia during prophylactic low-dose liposomal amphotericin B. No response to therapy was observed after increasing the dose of liposomal amphotericin B and addition of caspofungin, and breakthrough candidemia developed. Therapy switch to voriconazole did not prevent the development of lethal septic shock. Shortly before death, Scopulariopsis brevicaulis was cultured from bronchial secretions, and positive blood cultures demonstrated persistent candidemia due to Debaryomyces hansenii, teleomorph of Candida famata.
Wagner
D
D
Center for Infectious Diseases and Travel Medicine, University Hospital, Hugstetter Str. 55, 79106 Freiburg, Germany. info@if-Freiburg.de
Sander
Anna
A
Bertz
H
H
Finke
J
J
Kern
W V
WV
D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000741:Anemia, Aplastic / Q000150:complications; D001203:Ascomycota / Q000302:isolation & purification*; D001228:Aspergillosis / Q000188:drug therapy; D001826:Body Fluids / Q000382:microbiology; D000077336:Caspofungin; D004359:Drug Therapy, Combination; D054714:Echinocandins; D017809:Fatal Outcome; D016469:Fungemia / Q000188:drug therapy / Q000382:microbiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D055666:Lipopeptides; D008297:Male; D009181:Mycoses / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D010456:Peptides, Cyclic / Q000008:administration & dosage / Q000627:therapeutic use*; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use; D004718:Saccharomycetales / Q000302:isolation & purification*; D012772:Shock, Septic; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use; D065819:Voriconazole
D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077336:Caspofungin; D065819:Voriconazole