Breakthrough Hormographiella aspergillata Infections Arising in Neutropenic Patients Treated Empirically with Caspofungin

Hormographiella aspergillata, a filamentous basidiomycete, has rarely been involved in human infections. We describe 2 febrile neutropenic patients who developed a severe pulmonary infection due to H. aspergillata while receiving empirical caspofungin therapy for presumed fungal pneumonia. After int...

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Bibliographic Details
Published in:Journal of Clinical Microbiology 2011-01, Vol.49 (1), p.461-465
Main Authors: Suarez, Felipe, Olivier, Gaelle, Garcia-Hermoso, Dea, Randriamalala, Edouard, Ghez, David, Bruneau, Julie, Kauffmann-Lacroix, Catherine, Bougnoux, Marie-Elisabeth, Lortholary, Olivier
Format: Article
Language:English
Subjects:
Adult
Amphotericin B
Amphotericin B - therapeutic use
Antifungal Agents
Antifungal Agents - therapeutic use
Basidiomycetes
Basidiomycota
Basidiomycota - classification
Basidiomycota - genetics
Basidiomycota - isolation & purification
Biological and medical sciences
Case Reports
Caspofungin
DNA, Fungal
DNA, Fungal - chemistry
DNA, Fungal - genetics
Echinocandins
Echinocandins - therapeutic use
Female
Fever of Unknown Origin
Fever of Unknown Origin - drug therapy
Fundamental and applied biological sciences. Psychology
Fungi
Humans
Life Sciences
Lipopeptides
Lung Diseases, Fungal
Lung Diseases, Fungal - drug therapy
Male
Microbiology
Microbiology and Parasitology
Molecular Sequence Data
Mycology
Mycoses
Mycoses - diagnosis
Mycoses - microbiology
Neutropenia
Neutropenia - drug therapy
Sequence Analysis, DNA
Treatment Outcome
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Summary:Hormographiella aspergillata, a filamentous basidiomycete, has rarely been involved in human infections. We describe 2 febrile neutropenic patients who developed a severe pulmonary infection due to H. aspergillata while receiving empirical caspofungin therapy for presumed fungal pneumonia. After introduction of liposomal amphotericin B, one patient, who had neutrophil recovery, presented a favorable outcome, while the other, who remained neutropenic throughout the course of infection, died. Resistant fungi, including basidiomycetes, may emerge during empirical treatment with caspofungin in febrile neutropenic patients. A rapid switch to any other potent antifungal should be rapidly considered in case of failure of caspofungin in this setting.
ISSN:0095-1137
1098-660X
DOI:10.1128/JCM.01213-10