title: Detection of Mucor velutinosus in a blood culture after autologous peripheral blood stem cell transplantation : a pediatric case report.
abstract: Filamentous fungi were detected in the blood culture of a one-year-old boy after autologous peripheral blood stem cell transplantation. The patient was suspected to have aspergillosis and received micafungin. Fungi were isolated on potato dextrose agar medium and incubated at 37℃ for 2-5 days. Grayish, cottony colonies formed. A slide culture showed a spherical sporangium at the tips of the sporangiophores. The fungus could have been a zygomycete. The zygomycete was isolated from three blood cultures. The antifungal drug was changed from micafungin to liposomal amphotericin B, which resulted in an improvement in the patient's symptoms. Growth was observed at 37℃, but not 42℃ in a growth temperature test. Gene sequence analysis identified the fungus as Mucor velutinosus. To the best of our knowledge, this is the first time M. velutinosus has been detected in Japan, and this case is very rare. Zygomycetes are known to be pathogens that cause fungal infections in immunodeficient patients such as those with leukemia. They are difficult to identify by culture and are identified at autopsy in many cases. Therefore, culture examinations should be performed for immunodeficient patients with the consideration of zygomycetes.
authors.affiliation: Section of Infection Diseases, Laboratory Division of Clinical Support, Hiroshima University Hospital.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Joichi
authors.forename: Ikue
authors.initials: I
authors.lastname: Chijimatsu
authors.forename: Kyoko
authors.initials: K
authors.lastname: Yarita
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kamei
authors.forename: Mizuka
authors.initials: M
authors.lastname: Miki
authors.forename: Makoto
authors.initials: M
authors.lastname: Onodera
authors.forename: Masako
authors.initials: M
authors.lastname: Harada
authors.forename: Michiya
authors.initials: M
authors.lastname: Yokozaki
authors.forename: Masao
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ohge
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001769:Blood / Q000382:microbiology*; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D009089:Mucor / Q000235:genetics / Q000302:isolation & purification*; D009091:Mucormycosis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D036102:Peripheral Blood Stem Cell Transplantation; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B