title: Geotrichum capitatum septicaemia in a haematological patient after acute myeloid leukaemia relapse: identification using MALDI-TOF mass spectrometry and review of the literature.
abstract: Emerging fungal pathogens, such as Geotrichum capitatum, are often associated with poor prognosis and represent a new challenge in modern medicine. Invasive Geotrichum capitatum infection is rare and has been reported exclusively in patients who showed signs of severe immunodeficiency, particularly those affected by haematological malignancies. The optimal therapy against systemic geotricosis has not yet been identified due to limited data about its antifungal susceptibility. The use of several therapeutic strategies and the low number of cases treated does not allow identification of specific therapeutic protocols. Furthermore, in spite of antifungal therapy, mortality rates reach very high levels. We report a case of systemic Geotrichum capitatum infection in a 78-year-old male treated with salvage therapy after acute myeloid leukaemia (AML) relapse. Geotrichum capitatum was isolated from his blood culture and identified by using Vitek 2 and Maldi time-of-flight system (MALDI-TOF). The infection was unsuccessfully treated, despite in vitro susceptibility, with micafungin and liposomal amphotericin B.
authors.affiliation: Laboratory of Microbiology, Vito Fazzi Regional Hospital, Lecce, Italy; Institute of Microbiology, Universitá Cattolica del Sacro Cuore, Rome, Italy; Department of Clinical Pathology, Vito Fazzi Regional Hospital, Lecce, Italy; Department of Haematology, Vito Fazzi Regional Hospital, Lecce, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Miglietta
authors.affiliation: Laboratory of Microbiology, Vito Fazzi Regional Hospital, Lecce, Italy; Institute of Microbiology, Universitá Cattolica del Sacro Cuore, Rome, Italy; Department of Clinical Pathology, Vito Fazzi Regional Hospital, Lecce, Italy; Department of Haematology, Vito Fazzi Regional Hospital, Lecce, Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Vella
authors.affiliation: Laboratory of Microbiology, Vito Fazzi Regional Hospital, Lecce, Italy; Institute of Microbiology, Universitá Cattolica del Sacro Cuore, Rome, Italy; Department of Clinical Pathology, Vito Fazzi Regional Hospital, Lecce, Italy; Department of Haematology, Vito Fazzi Regional Hospital, Lecce, Italy.
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Faneschi
authors.affiliation: Laboratory of Microbiology, Vito Fazzi Regional Hospital, Lecce, Italy; Institute of Microbiology, Universitá Cattolica del Sacro Cuore, Rome, Italy; Department of Clinical Pathology, Vito Fazzi Regional Hospital, Lecce, Italy; Department of Haematology, Vito Fazzi Regional Hospital, Lecce, Italy.
authors.forename: Giambattista
authors.initials: G
authors.lastname: Lobreglio
authors.affiliation: Laboratory of Microbiology, Vito Fazzi Regional Hospital, Lecce, Italy; Institute of Microbiology, Universitá Cattolica del Sacro Cuore, Rome, Italy; Department of Clinical Pathology, Vito Fazzi Regional Hospital, Lecce, Italy; Department of Haematology, Vito Fazzi Regional Hospital, Lecce, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Rizzo
authors.affiliation: Laboratory of Microbiology, Vito Fazzi Regional Hospital, Lecce, Italy; Institute of Microbiology, Universitá Cattolica del Sacro Cuore, Rome, Italy; Department of Clinical Pathology, Vito Fazzi Regional Hospital, Lecce, Italy; Department of Haematology, Vito Fazzi Regional Hospital, Lecce, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Palumbo
authors.affiliation: Laboratory of Microbiology, Vito Fazzi Regional Hospital, Lecce, Italy; Institute of Microbiology, Universitá Cattolica del Sacro Cuore, Rome, Italy; Department of Clinical Pathology, Vito Fazzi Regional Hospital, Lecce, Italy; Department of Haematology, Vito Fazzi Regional Hospital, Lecce, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Palumbo
authors.affiliation: Laboratory of Microbiology, Vito Fazzi Regional Hospital, Lecce, Italy; Institute of Microbiology, Universitá Cattolica del Sacro Cuore, Rome, Italy; Department of Clinical Pathology, Vito Fazzi Regional Hospital, Lecce, Italy; Department of Haematology, Vito Fazzi Regional Hospital, Lecce, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Renzo
authors.affiliation: Laboratory of Microbiology, Vito Fazzi Regional Hospital, Lecce, Italy; Institute of Microbiology, Universitá Cattolica del Sacro Cuore, Rome, Italy; Department of Clinical Pathology, Vito Fazzi Regional Hospital, Lecce, Italy; Department of Haematology, Vito Fazzi Regional Hospital, Lecce, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Pizzolante
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003128:Coma / Q000209:etiology; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000627:therapeutic use; D017809:Fatal Outcome; D005848:Geotrichum / Q000302:isolation & purification* / Q000472:pathogenicity*; D006801:Humans; D016867:Immunocompromised Host; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D055666:Lipopeptides / Q000627:therapeutic use; D008297:Male; D000077551:Micafungin; D012008:Recurrence; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*; D017211:Treatment Failure
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077551:Micafungin