Infección fúngica invasiva por Saprochaete capitata en un niño con aplasia medular / Invasive fungal infection by Saprochaete capitata in a child with bone marrow aplasia

RESUMEN Saprochaete capitata es una causa rara de infección fúngica invasiva en pacientes inmunocomprometidos con alta mortalidad y resistencia antifúngica. Presentamos el caso de un niño de cinco años con diagnóstico de aplasia medular, sometido a trasplante de progenitores hematopoyéticos (TPH), que cursó con neutropenia febril persistente, dolor abdominal intenso, aparición de lesiones maculopapulares en piel y deterioro de la función renal. Se identificó la presencia de S. capitata, en hemocultivos transcatéter venoso central. Esta infección fúngica invasiva resulta ser rara, pero emergente y potencialmente mortal, en pacientes con neutropenia febril persistente y uso prolongado de dispositivos invasivos intravasculares como catéter venoso central.

ABSTRACT Saprochaete capitata is a rare cause of invasive fungal infection in immunocompromised patients with high mortality and antifungal resistance. We present the case of a 5-year-old boy with bone marrow aplasia, who underwent hematopoietic stem cell transplantation (HSCT) and presented persistent febrile neutropenia, abdominal pain, appearance of maculopapular lesions on the skin, and impaired renal function. The presence of S. capitata was identified by blood culture from a central venous catheter. This invasive fungal infection is rare but emergent and life-threatening, especially in immunocompromised patients with persistent febrile neutropenia and prolonged use of invasive devices such as central venous catheters.

Rare severe mycotic infections in children receiving empirical caspofungin treatment for febrile neutropenia

ABSTRACTEmpirical antifungal therapy is most often given to patients with leukemia. However breakthrough fungal infections under antifungal therapy are not uncommon. Four children, with hematologic malignant disease developed mycotic breakthrough infections while on empirical caspofungin treatment for a median of 14 (range 11-19) days. Trichosporon asahii was detected in the blood culture of two patients and Geotrichum capitatum in the other two (one patient also had positive cerebrospinal fluid culture). Because the patients' clinical situation worsened, voriconazole was empirically added for two patients three and five days before the agent was detected. The first sterile blood culture was obtained 3-7 days of voriconazole treatment. All patients reached clear cultures but one patient died. One patient with central nervous system infection with G. capitatum had severe neurological sequelae. Very severe fungal infections can occur during empirical caspofungin therapy. Therefore, patients should be followed closely.

Dermatomicosis: análisis retrospectivo de 2,336 pacientes, 1976-1980

Se presentan 2,336 casos de dermatomicosis observados en el periodo 1976-1980 en el Laboratorio de Micología de la Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia. El diagnóstico de dermatofitosis se comprobó en 1.276 casos (52.1 por ciento); candidiasis se presentó en 870 casos (35.5 por ciento), pitiriasis en 150 casos (6.1 por ciento), tricosporiasis en 90 casos (3.7 por ciento), geotricosis en 52 casos (2.1 por ciento) y varios en 13 casos (0.5 por ciento); de estos últimos es de resaltar el aislamiento de dos casos de M. persicolor y dos de T. verrucosum. El dermatofito más frecuentemente aislado fue el T. mentagrophytes (32.7 por ciento) seguido por el T. rubrum (23.0 por ciento), el E. floccosum (21.7 por ciento), el T. tonsurans (11.7 por ciento) y en último lugar los Microsporum sp. (10.9 por ciento)