References:
  1. Kaplan E, Al-Hatmi AMS, Ilkit M, Gerrits vanden Ende AHG, Hagen F, Meis JF, et al. Molecular Diagnostics of Arthroconidial Yeasts, Frequent Pulmonary Opportunists. J Clin Microbiol. 2017;56(1):e01427-17. Published 2017 Dec 26. doi:10.1128/JCM.01427-17
  2. El Zein S, Hindy JR, Kanj SS. Invasive Saprochaete Infections: An Emerging Threat to Immunocompromised Patients. Pathogens. 2020;9(11):922. Published 2020 Nov 7. doi:10.3390/pathogens9110922
  3. Desnos-Ollivier M, Blanc C, Garcia-Hermoso D, Hoinard D, Alanio A, Dromer F. Misidentification of Saprochaete clavata as Magnusiomyces capitatus in clinical isolates: utility of internal transcribed spacer sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry and importance of reliable databases. J Clin Microbiol. 2014;52(6):2196-2198. doi:10.1128/JCM.00039-14
  4. Noster J, Koeppel MB, Desnos-Olivier M, Aigner M, Bader O, Dichtl K, et al. Bloodstream Infections Caused by Magnusiomyces capitatus and Magnusiomyces clavatus: Epidemiological, Clinical, and Microbiological Features of Two Emerging Yeast Species. Antimicrob Agents Chemother. 2022;66(2):e0183421. doi:10.1128/AAC.01834-21
  5. Pamidimukkala U, Kancharla A, Sudhaharan S, Gundeti S, Mandarapu S, Nagalla VK, et al. Isolation of the Rare Opportunistic Yeast Saprochaete capitata from Clinical Samples-Experience from a Tertiary Care Hospital in Southern India and a Brief Review of the Literature. J Clin Diagn Res. 2017;11(9):DC36-DC42. doi:10.7860/JCDR/2017/30339.10669
  6. Buchta V, Bolehovská R, Hovorková E, Cornely OA, Seidel D, Žák P. Saprochaete clavata Invasive Infections - A New Threat to Hematological-Oncological Patients. Front Microbiol. 2019;10:2196. Published 2019 Oct 29. doi:10.3389/fmicb.2019.02196
  7. Menu E, Criscuolo A, Desnos-Ollivier M, Cassagne C, D’Incan E, Furst S, et al. Saprochaete clavata Outbreak Infecting Cancer Center through Dishwasher. Emerg Infect Dis. 2020;26(9):2031-2038. doi:10.3201/eid2609.200341
  8. Gurgui M, Sanchez F, March F, Lopez-Contreras J, Martino R, Cotura A, et al. Nosocomial outbreak of Blastoschizomyces capitatus associated with contaminated milk in a haematological unit. J Hosp Infect. 2011;78(4):274-278. doi:10.1016/j.jhin.2011.01.027
  9. Vaux S, Criscuolo A, Desnos-Ollivier M, Diancourt L, Tarnaud C, Vandenbogaert M, et al. Multicenter outbreak of infections by Saprochaete clavata, an unrecognized opportunistic fungal pathogen. mBio. 2014;5(6):e02309-14. Published 2014 Dec 16. doi:10.1128/mBio.02309-14
  10. Lajolo C, Rupe C, Schiavelli A, Gioco G, Metafuni E, Contaldo M, et al. Saprochaete clavata Infection in Immunosuppressed Patients: Systematic Review of Cases and Report of the First Oral Manifestation, Focusing on Differential Diagnosis. Int J Environ Res Public Health. 2021;18(5):2385. Published 2021 Mar 1. doi:10.3390/ijerph18052385
  11. Caldas JP, Silva-Pinto A, Faustino AS, Figueiredo P, Sarmento A, Santos L. Septic shock due to co-infection with Legionella pneumophila and Saprochaete clavata. IDCases. 2021;27:e01369. Published 2021 Dec 20. doi:10.1016/j.idcr.2021.e01369
  12. Kangül H, Özcan N, Uzuner N, Mete M, Mert Erginer U. Saprochaete clavata (Geotrichum clavatum) septicemia in a patient with multiple myeloma; An emerging case from Southeastern Turkey. Curr Med Mycol. 2020;6(4):66-69. doi:10.18502/cmm.6.4.5440
  13. Prigitano A, Cavanna C, Passera M, Gelmi M, Sala E, Ossi C, et al. Evolution of fungemia in an Italian region. J Mycol Med. 2020;30(1):100906. doi:10.1016/j.mycmed.2019.100906
  14. Lacroix, C, Brethon, B, Boissel, N, Desnos, M, Leblanc, T, Raffoux, E. Geotrichum clavatum an emerging pathogen responsible for invasive infection in two neutropenic leukemia patients. J. Chemother. 2007, 19:sup3, 81. doi:10.1080/1120009X.2007.11782450
  15. de Almeida Júnior JN, Sztajnbok J, da Silva Junior AR, Vieira VA, Galastri AL, Bissoli L, et al. Rapid identification of moulds and arthroconidial yeasts from positive blood cultures by MALDI-TOF mass spectrometry. Med Mycol. 2016;54(8):885-889. doi:10.1093/mmy/myw044
  16. Liu X, Zhou W, Jiang Y, Kuang L. Invasive Fungal Infection Caused by Geotrichum clavatum in a Child with Acute Leukemia: First Documented Case from Mainland China. Jpn J Infect Dis. 2019;72(2):130-132. doi:10.7883/yoken.JJID.2018.351
  17. Leoni M, Riccardi N, Rotulo GA, Godano E, Faraci M, Bandettini R, et al. Magnusiomyces clavatus infection in a child after allogeneic hematotopoetic stem cell transplantation: Diagnostic and therapeutic implications. Med Mycol Case Rep. 2018;23:65-67. Published 2018 Dec 21. doi:10.1016/j.mmcr.2018.12.005
  18. Wee LWY, Ling HY, Chong CY, Soe MN, Koh MJA. A rare case of purpuric rash caused by Saprochaete clavata in a pediatric patient with acute leukemia. Pediatr Dermatol. 2019;36(6):990-991. doi:10.1111/pde.13963
  19. Lo Cascio G, Vincenzi M, Soldani F, De Carolis E, Maccacaro L, Sorrentino A, et al. Outbreak of Saprochaete clavata Sepsis in Hematology Patients: Combined Use of MALDI-TOF and Sequencing Strategy to Identify and Correlate the Episodes. Front Microbiol. 2020;11:84. Published 2020 Jan 31. doi:10.3389/fmicb.2020.00084
  20. Özkaya E, Tosun İ, Tüfekçİ EF, Buruk CK, Kaklıkkaya N, Aydın F. Identification and antifungal susceptibility of Saprochaete clavata from invasive infections in Turkey. Acta Microbiol Immunol Hung. 2020;67(4):252-257. Published 2020 Nov 30. doi:10.1556/030.2020.01301
  21. Tuon F, Kraft L, Ribeiro V, Rodrigues A, Motta F. SAPROCHAETE CLAVATA ASSOCIATED WITH INFECTION IN A PEDIATRIC PATIENT IN BRAZIL: CASE REPORT WITH MORPHOLOGICAL DESCRIPTION, ANTIFUNGAL SUSCEPTIBILITY, CHARACTERIZATION AND EVALUATION OF BIOFILM [in Porteguese]. The Brazilian Journal of Infectious Diseases. 2022;26(supp1):104. https://doi.org/10.1016/j.bjid.2021.101936.
  22. Goupillou P, Costa D, Gargala G, Favennec L, Rouzaud C, Muraine M, et al. Saprochaete clavata Chorioretinitis in a Post-chemotherapy Immunocompromised 9-Year-Old Child [published online ahead of print, 2022 May 19]. Ocul Immunol Inflamm. 2022;1-4. doi:10.1080/09273948.2022.2070502
  23. Park H, Youk J, Shin DY, Hong J, Kim I, Kim NJ, et al. Micafungin prophylaxis for acute leukemia patients undergoing induction chemotherapy. BMC Cancer. 2019;19(1):358. Published 2019 Apr 16. doi:10.1186/s12885-019-5557-9
Figure 1: A. MRI Brain showing left superior parietal lobule leptomeningeal enhancement seen with FLAIR hyperintensity.B. CT Chest, abdomen and pelvis with contrast showing hepatosplenomegaly with innumerable nodules in the liver, spleen, kidneys, and pancreas without discrete drainable abscess. C.MRI brain showing a peripherally enhancing lesion in left parietal region involving cortex and extra-axial space with surrounding edema and numerous punctate foci of enhancement both supra and infratentorial likely representing foci of disseminated fungemia. D. Repeat CT Chest, abdomen and pelvis ~6 weeks later with ongoing hepatosplenomegaly with worsening of liver lesions, no change to splenic lesions, and improvement of lesions in lungs, pancreas, and kidneys.
Figure 2: A. The patient’s daily recorded temperature correlating with treatment. First yellow arrow was the patient’s first fever with her seizure. Second arrow identifies when voriconazole (VCZ) and amphotericin-B (Amp-B) was started. Third arrow identifies the last positive blood culture. Fourth arrow was when flucytosine (5-FC) was added. Fifth arrow represents the time at which surgery was performed to drain the intracranial abscess. Sixth arrow is when blinatumomab was initiated. Final arrow is when the patient was discharged after over 7 days without fevers on three antifungal agents. B. ReportedMagnusiomyces clavatus infections by country of origin. This report highlighted with a yellow pin.