title: A cluster of Geotrichum clavatum (Saprochaete clavata) infection in haematological patients: a first Italian report and review of literature.
abstract: Invasive fungal infections, usually Aspergillus and Candida, represent a major cause of morbidity and mortality in patients with malignant haematological diseases, but in the last years rare fungal infections have more frequently been reported. Here, we report the clinical history of three patients affected with haematological malignancies who developed an infection caused by Geotrichum (G.) clavatum. Two out of three patients were affected by acute myeloid leukaemia (AML), and one by mantle cell lymphoma (MCL). All patients received cytarabine-based chemotherapeutic regimens and developed G. clavatum infection within 3 weeks from therapy initiation. In all cases, G. clavatum was isolated from central venous catheter and peripheral blood cultures. In vitro susceptibility test confirmed an intrinsic resistance to echinocandins and, in all cases, visceral localisations (spleen, liver and lung) were documented by total body computed tomography (CT) scan. A prolonged antifungal therapy with high doses liposomal amphotericin-B was necessary to obtain fever resolution. Only the patient with MCL died while the other two AML recovered, and one of them after received an allogeneic stem cell transplantation. We consecutively reviewed all published cases of infection caused by G. clavatum. Our experience and literature review indicate that G. clavatum can cause invasive infection in haematological patients, mainly in those with acute leukaemia.
authors.affiliation: Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italia.
authors.forename: Maria Ilaria
authors.initials: MI
authors.lastname: Del Principe
authors.affiliation: Clinica di Malattie Infettive, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Roma, Italia.
authors.forename: Loredana
authors.initials: L
authors.lastname: Sarmati
authors.affiliation: Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italia.
authors.forename: Mariagiovanna
authors.initials: M
authors.lastname: Cefalo
authors.affiliation: Dipartimento di Medicina e Chirurgia, Università Tor Vergata, Roma, Italia.
authors.forename: Carla
authors.initials: C
authors.lastname: Fontana
authors.affiliation: Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italia.
authors.forename: Giovanna
authors.initials: G
authors.lastname: De Santis
authors.affiliation: Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italia.
authors.forename: Francesco
authors.initials: F
authors.lastname: Buccisano
authors.affiliation: Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italia.
authors.forename: Luca
authors.initials: L
authors.lastname: Maurillo
authors.affiliation: Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italia.
authors.forename: Eleonora
authors.initials: E
authors.lastname: De Bellis
authors.affiliation: Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italia.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Postorino
authors.affiliation: Istituto di Farmacologia Translazionale, Dipartimento di Medicina, CNR, Roma, Italia.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sconocchia
authors.affiliation: Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italia.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Del Poeta
authors.affiliation: Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Sanguinetti
authors.affiliation: Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italia.
authors.forename: Sergio
authors.initials: S
authors.lastname: Amadori
authors.affiliation: Istituto di Ematologia, Università Cattolica del Sacro Cuore, Roma, Italia.
authors.forename: Livio
authors.initials: L
authors.lastname: Pagano
authors.affiliation: Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italia.
authors.forename: Adriano
authors.initials: A
authors.lastname: Venditti
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D062905:Central Venous Catheters / Q000382:microbiology; D025141:Drug Resistance, Fungal; D054714:Echinocandins / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D005847:Geotrichosis / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D005848:Geotrichum / Q000187:drug effects; D019337:Hematologic Neoplasms / Q000150:complications* / Q000453:epidemiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000072742:Invasive Fungal Infections / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology; D007558:Italy; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D008099:Liver / Q000000981:diagnostic imaging / Q000382:microbiology; D008168:Lung / Q000000981:diagnostic imaging / Q000382:microbiology; D020522:Lymphoma, Mantle-Cell / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D013154:Spleen / Q000000981:diagnostic imaging / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; C068538:liposomal amphotericin B; D000666:Amphotericin B
keywords: (1→3)-β-d-glucan; Geotrichum clavatum; acute myeloid leukaemia; emerging yeast infections; fungaemia; liposomal amphotericin-B; susceptibility tests