1887

Abstract

Geotrichum candidum is a saprophytic yeast known to colonize the human skin, respiratory tract and gastrointestinal tract. It can cause local or disseminated disease (geotrichosis), mainly in the immunocompromised host. Trauma, indwelling catheter use, prolonged broad-spectrum antibiotic treatment and critical illness have also been implicated as risk factors. Here we report the first case, to our knowledge, of cutaneous G. candidum infection in a burn patient. The isolate had a high amphotericin B minimum inhibitory concentration (MIC) and the patient experienced concomitant Candida orthopsilosis fungaemia, and so was treated with a combination of voriconazole and micafungin. This case highlights the importance of source control, rapid identification of G. candidum infection and MIC determination to guide antifungal therapy, which typically consists of amphotericin B with or without flucytosine or voriconazole alone. Clinicians should be aware of geotrichosis as a clinical entity in burn patients as well as in the immunocompromised. Antifungal resistance and breakthrough disease are an ongoing concern due to the increasing number of immunocompromised at-risk patients and the use of routine mould prophylaxis.

Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000001
2019-03-20
2020-01-28
Loading full text...

Full text loading...

/deliver/fulltext/acmi/1/1/acmi000001.html?itemId=/content/journal/acmi/10.1099/acmi.0.000001&mimeType=html&fmt=ahah

References

  1. Alper I, Frenette M, Labrie S. Ribosomal DNA polymorphisms in the yeast Geotrichum candidum. Fungal Biol 2011;115:1259–1269 [CrossRef]
    [Google Scholar]
  2. Batt CA, Robinson RK. Encyclopedia of Food Microbiology Elsevier Science; 2014
    [Google Scholar]
  3. Sheehy TW, Honeycutt BK, Spencer JT. Geotrichum septicemia. JAMA 1976;235:1035–1037 [CrossRef]
    [Google Scholar]
  4. Bonifaz A, Vázquez-González D, Macías B, Paredes-Farrera F, Hernández MA et al. Oral geotrichosis: report of 12 cases. J Oral Sci 2010;52:477–483 [CrossRef]
    [Google Scholar]
  5. Vasei M, Imanieh MH. Duodenal colonization by Geotrichum candidum in a child with transient low serum levels of IgA and IgM. APMIS 1999;107:681–684 [CrossRef]
    [Google Scholar]
  6. Jagirdar J, Geller SA, Bottone EJ. Geotrichum candidum as a tissue invasive human pathogen. Hum Pathol 1981;12:668–671 [CrossRef]
    [Google Scholar]
  7. Ng KP, Soo-Hoo TS, Koh MT, Kwan PW. Disseminated Geotrichum infection. Med J Malaysia 1994;49:424–426
    [Google Scholar]
  8. Henrich TJ, Marty FM, Milner DA Jr, Thorner AR. Disseminated Geotrichum candidum infection in a patient with relapsed acute myelogenous leukemia following allogeneic stem cell transplantation and review of the literature. Transpl Infect Dis 2009;11:458–462 [CrossRef]
    [Google Scholar]
  9. André N, Coze C, Gentet JC, Perez R, Bernard JL. Geotrichum candidum septicemia in a child with hepatoblastoma. Pediatr Infect Dis J 2004;23:86 [CrossRef]
    [Google Scholar]
  10. Kassamali H, Anaissie E, Ro J, Rolston K, Kantarjian H et al. Disseminated Geotrichum candidum infection. J Clin Microbiol 1987;25:1782–1783
    [Google Scholar]
  11. Heinic GS, Greenspan D, MacPhail LA, Greenspan JS. Oral Geotrichum candidum infection associated with HIV infection. A case report. Oral Surg Oral Med Oral Pathol 1992;73:726–728 [CrossRef]
    [Google Scholar]
  12. Ghamande AR, Landis FB, Snider GL. Bronchial geotrichosis with fungemia complicating bronchogenic carcinoma. Chest 1971;59:98–101 [CrossRef]
    [Google Scholar]
  13. Sfakianakis A, Krasagakis K, Stefanidou M, Maraki S, Koutsopoulos A et al. Invasive cutaneous infection with Geotrichum candidum: sequential treatment with amphotericin B and voriconazole. Med Mycol 2007;45:81–84 [CrossRef]
    [Google Scholar]
  14. Arendrup MC, Boekhout T, Akova M, Meis JF, Cornely OA et al. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of rare invasive yeast infections. Clin Microbiol Infect 2014;20:76–98 [CrossRef]
    [Google Scholar]
  15. Durán Graeff L, Seidel D, Vehreschild MJ, Hamprecht A, Kindo A et al. Invasive infections due to Saprochaete and Geotrichum species: report of 23 cases from the FungiScope registry. Mycoses 2017;60:273–279 [CrossRef]
    [Google Scholar]
  16. Kasantikul V, Chamsuwan A. Brain abscesses due to Geotrichum candidum. Southeast Asian J Trop Med Public Health 1995;26:805–807
    [Google Scholar]
  17. Myint T, Dykhuizen MJ, McDonald CH, Ribes JA. Post operative fungal endopthalmitis due to Geotrichum candidum. Med Mycol Case Rep 2015;10:4–6 [CrossRef]
    [Google Scholar]
  18. Suryawanshi R, Deo S, Suryawanshi M. Ocular Geotrichosis. JKIMSU 2015;4:185–187
    [Google Scholar]
  19. Hanada K, Miyokawa N, Sano A, Igarashi S, Yoshida A. Fungal dacryocystitis with cacosmia after penetrating keratoplasty–taxonomy and identification of pathogenic fungi based on DNA sequence analysis. Nippon Ganka Gakkai Zasshi 2012;116:1144–1149
    [Google Scholar]
  20. Tricerri R, Oppezzi M, Dodero M, Piersantelli N, Guida B et al. Esophageal ulcer caused by Geotrichum candidum in a case of AIDS. Pathologica 1990;82:187–191
    [Google Scholar]
  21. Popescu L, Verescu O, Crişan E, Vlădescu A. Secondary active-evolutive cavitary pulmonary tuberculosis of the apicodorsal segment of the left upper lobe associated with bronchial tuberculosis and bronchial geotrichosis. Pneumoftiziologia 1997;46:127–130
    [Google Scholar]
  22. Yegneswaran Prakash P, Seetaramaiah VK, Thomas J, Khanna V, Rao SP. Renal fungal bezoar owing to Geotrichum candidum. Med Mycol Case Rep 2012;1:63–65 [CrossRef]
    [Google Scholar]
  23. Hrdy DB, Nassar NN, Rinaldi MG. Traumatic joint infection due to Geotrichum candidum. Clin Infect Dis 1995;20:468–469 [CrossRef]
    [Google Scholar]
  24. Radic M, Goic Barisic I, Kuscevic D, Novak A, Tonkic M et al. Geotrichum capitatum respiratory tract infection in a patient with polytrauma. Infez Med 2015;23:270–274
    [Google Scholar]
  25. Liu MZ. Need for more emphasis on fungal infection in burns. Zhonghua Wai Ke Za Zhi 1992;30:554–555, 73
    [Google Scholar]
  26. Ramos G, Cornistein W, Cerino GT, Nacif G. Systemic antimicrobial prophylaxis in burn patients: systematic review. J Hosp Infect 2017;97:105–114 [CrossRef]
    [Google Scholar]
  27. Struck MF, Gille J. Fungal infections in burns: a comprehensive review. Ann Burns Fire Disasters 2013;26:147–153
    [Google Scholar]
  28. Ugburo AO, Atoyebi OA, Oyeneyin JO, Sowemimo GO. An evaluation of the role of systemic antibiotic prophylaxis in the control of burn wound infection at the Lagos University Teaching Hospital. Burns 2004;30:43–48 [CrossRef]
    [Google Scholar]
  29. Domsch KH, Gams W, Anderson TH. Compendium of Soil Fungi Academic Press; 1980
    [Google Scholar]
  30. Colombo AL, Padovan AC, Chaves GM. Current knowledge of Trichosporon spp. and trichosporonosis. Clin Microbiol Rev 2011;24:682–700 [CrossRef]
    [Google Scholar]
  31. Sugui JA, Kwon-Chung KJ, Juvvadi PR, Latge JP, Steinbach WJ. Aspergillusfumigatus and related species. Cold Spring Harb Perspect Med 2015;5:a019786 [CrossRef]
    [Google Scholar]
  32. Li HM, Du HT, Liu W, Wan Z, Li RY. Microbiological characteristics of medically important Trichosporon species. Mycopathologia 2005;160:217–225 [CrossRef]
    [Google Scholar]
  33. Fuquay JW, Fox PF, McSweeney PLH. Encyclopedia of Dairy Sciences, 2nd ed. Academic Press; 2011
    [Google Scholar]
  34. Martin MV, Schneidau JD Jr. A simple and reliable assimilation test for the identification of Candida species. Am J Clin Pathol 1970;53:875–879 [CrossRef]
    [Google Scholar]
  35. De Hoog GS, Smith MT. Ribosomal gene phylogeny and species delimitation in Geotrichum and its teleomorphs. Stud Mycol 2004;50:489–515
    [Google Scholar]
  36. Ghelardi E, Pichierri G, Castagna B, Barnini S, Tavanti A et al. Efficacy of chromogenic Candida agar for isolation and presumptive identification of pathogenic yeast species. Clin Microbiol Infect 2008;14:141–147 [CrossRef]
    [Google Scholar]
  37. Polacheck I, Salkin IF, Kitzes-Cohen R, Raz R. Endocarditis caused by Blastoschizomyces capitatus and taxonomic review of the genus. J Clin Microbiol 1992;30:2318–2322
    [Google Scholar]
  38. Giacchino M, Chiapello N, Bezzio S, Fagioli F, Saracco P et al. Aspergillus galactomannan enzyme-linked immunosorbent assay cross-reactivity caused by invasive Geotrichum capitatum. J Clin Microbiol 2006;44:3432–3434 [CrossRef]
    [Google Scholar]
  39. Persat F, Ranque S, Derouin F, Michel-Nguyen A, Picot S et al. Contribution of the (1-->3)-beta-D-glucan assay for diagnosis of invasive fungal infections. J Clin Microbiol 2008;46:1009–1013 [CrossRef]
    [Google Scholar]
  40. Gente S, Sohier D, Coton E, Duhamel C, Gueguen M. Identification of Geotrichum candidum at the species and strain level: proposal for a standardized protocol. J Ind Microbiol Biotechnol 2006;33:1019–1031 [CrossRef]
    [Google Scholar]
  41. Dannaoui E, Lortholary O, Raoux D, Bougnoux ME, Galeazzi G et al. Comparative in vitro activities of caspofungin and micafungin, determined using the method of the European Committee on antimicrobial susceptibility testing, against yeast isolates obtained in France in 2005–2006. Antimicrob Agents Chemother 2008;52:778–781 [CrossRef]
    [Google Scholar]
  42. Lass-Flörl C, Mayr A, Perkhofer S, Hinterberger G, Hausdorfer J et al. Activities of antifungal agents against yeasts and filamentous fungi: assessment according to the methodology of the European Committee on antimicrobial susceptibility testing. Antimicrob Agents Chemother 2008;52:3637–3641 [CrossRef]
    [Google Scholar]
  43. ClinicalTrials.govIsavuconazole (BAL8557) in the Treatment of Candidemia and Other Invasive Candida Infections Bethesda, MD: NIH US National Library of Medicine; 2017;http://www.clinicaltrials.gov/ct2/show/NCT00413218
  44. Pfaller MA, Pappas PG, Wingard JR. Invasive fungal pathogens: current epidemiological trends. Clin Infect Dis 2006;43:S3–S14 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/acmi/10.1099/acmi.0.000001
Loading
/content/journal/acmi/10.1099/acmi.0.000001
Loading

Data & Media loading...

Most cited articles

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error