Septic shock induced by Lecythophora mutabilis in a patient with mitochondrial encephalomyopathy.
Invasive fungal infection (IFI) caused by Lecythophora mutabilis occasionally occurs in patients with impaired host immunity; such patients had eosinophilia at onset, and surviving patients were treated with fungal cell-membrane-targeted drugs. An 18-year-old man with mitochondrial encephalomyopathy accompanied with refractory anaemia and chronic renal failure developed septic shock caused by L. mutabilis, which was detected from a blood culture, and was identified morphologically and genetically. During the course of the infection, he had eosinophilia, although beta-d-glucan levels were within the normal range. He was treated with micafungin, but deteriorated and died, despite his treatment being changed to liposomal amphotericin B. On the basis of this we suggest that IFI caused by L. mutabilis should be suspected when a compromised host develops infection and eosinophilia, and that antifungal drugs that target beta-d-glucan are not advisable.
Taniguchi
Yuki
Y
Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
Taketani
Takeshi
T
Department of Pediatrics, Shimane University School of Medicine, Shimane, Japan.|Division of Blood Transfusion, Shimane University Hospital, Shimane, Japan.
Moriyama
Hidehiko
H
Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
Moriki
Shoji
S
Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
Nishimura
Kazuko
K
Medical Mycology Research Center, Chiba University, Chiba, Japan.
Sato
Emi
E
Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
Notsu
Yasuko
Y
Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
Higuchi
Tsuyoshi
T
Department of Pediatrics, Shimane University School of Medicine, Shimane, Japan.
Sugitani
Yuichiro
Y
Department of Pediatrics, Shimane University School of Medicine, Shimane, Japan.
Yasuda
Kenji
K
Department of Pediatrics, Shimane University School of Medicine, Shimane, Japan.
Nagai
Atsushi
A
Department of Laboratory Medicine, Shimane University School of Medicine, Shimane, Japan.
Yamaguchi
Seiji
S
Department of Pediatrics, Shimane University School of Medicine, Shimane, Japan.
Shibata
Hiroshi
H
Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
Masuda
Junichi
J
Department of Laboratory Medicine, Shimane University School of Medicine, Shimane, Japan.
D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001203:Ascomycota / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity; D054714:Echinocandins / Q000627:therapeutic use; D006801:Humans; D034062:Insomnia, Fatal Familial; D055666:Lipopeptides / Q000627:therapeutic use; D008297:Male; D000077551:Micafungin; D017237:Mitochondrial Encephalomyopathies / Q000150:complications*; D009181:Mycoses / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology*; D011015:Pneumonia, Aspiration / Q000150:complications / Q000382:microbiology; D012772:Shock, Septic / Q000150:complications* / Q000382:microbiology*
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077551:Micafungin