title: Septic shock induced by Lecythophora mutabilis in a patient with mitochondrial encephalomyopathy.
abstract: 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.
authors.affiliation: Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Taniguchi
authors.affiliation: Department of Pediatrics, Shimane University School of Medicine, Shimane, Japan.|Division of Blood Transfusion, Shimane University Hospital, Shimane, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Taketani
authors.affiliation: Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Moriyama
authors.affiliation: Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Moriki
authors.affiliation: Medical Mycology Research Center, Chiba University, Chiba, Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Nishimura
authors.affiliation: Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Sato
authors.affiliation: Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Notsu
authors.affiliation: Department of Pediatrics, Shimane University School of Medicine, Shimane, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Higuchi
authors.affiliation: Department of Pediatrics, Shimane University School of Medicine, Shimane, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Sugitani
authors.affiliation: Department of Pediatrics, Shimane University School of Medicine, Shimane, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yasuda
authors.affiliation: Department of Laboratory Medicine, Shimane University School of Medicine, Shimane, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nagai
authors.affiliation: Department of Pediatrics, Shimane University School of Medicine, Shimane, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Yamaguchi
authors.affiliation: Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shibata
authors.affiliation: Department of Laboratory Medicine, Shimane University School of Medicine, Shimane, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Masuda
mesh_terms: 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*
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077551:Micafungin