title: Fatal Cyberlindnera fabianii fungemia in a patient with mixed phenotype acute leukemia after umbilical cord blood transplantation.
abstract: We report a case of Cyberlindnera fabianii fungemia after umbilical cord blood transplantation (CBT). A 69-year-old woman was diagnosed as having mixed phenotype acute leukemia. The patient received CBT for primary refractory disease. After preconditioning chemotherapy, the patient's condition deteriorated, leading to acute respiratory failure from capillary leak syndrome and consequent admittance to the intensive care unit. The patient recovered temporarily following the administration of noninvasive positive pressure ventilation and continuous hemodiafiltration, but died of fungemia with the presence of yeast-like cells 15 days post-CBT. The yeast-like cells were analyzed by sequencing of the D1/D2 domain of the large subunit and the internal transcribed spacer domain, and were identified as C. fabianii. This case shows that molecular genetic-based methods may be effective for detecting undetermined invasive fungal infections in stem cell transplantation settings.
authors.affiliation: Department of Hematology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. patchsei@yahoo.co.jp.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Katagiri
authors.affiliation: Department of Hematology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Moritaka
authors.initials: M
authors.lastname: Gotoh
authors.affiliation: Laboratory of Space and Environmental Medicine, Graduate School of Medicine, Teikyo University, Tokyo, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Tone
authors.affiliation: Department of Hematology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Daigo
authors.initials: D
authors.lastname: Akahane
authors.affiliation: Department of Hematology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Hematology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Ohyashiki
authors.affiliation: Laboratory of Space and Environmental Medicine, Graduate School of Medicine, Teikyo University, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Makimura
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects; D005260:Female; D005312:Fetal Blood / Q000637:transplantation*; D016469:Fungemia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D015456:Leukemia, Biphenotypic, Acute / Q000150:complications* / Q000628:therapy*; D010843:Pichia / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D000935:Antifungal Agents
keywords: Cyberlindnera fabianii; Mixed phenotype acute leukemia; Umbilical cord blood transplantation