Case of Geotrichum capitatum septicemia successfully resolved by the use of liposomal amphotericin B in a patient with acute myeloid leukemia

Abstract

Background: Geotrichum capitatum infection is a rare condition and it has only been reported in immune-compromised patients. The prognosis is poor, with a mortality rate between 50-90%. Case presentation: Here we report a case of Geotrichum capitatum septicemia in a neutropenic patient undergoing induction chemotherapy for acute myeloblastic leukemia. At day +24 from the beginning of chemotherapy, the patient’s blood cultures were positive for Geotrichum capitatum. When we received the antimicogram a therapy with liposomal amphotericin B (3 mg/kg/day) was started. After 15 days of antifungal treatment, the patient’s clinical condition had dramatically improved and at the twenty-first day of antifungal treatment the blood culture was negative for Geotrichum capitatum. On day +47 from the start of induction, the patient died in hematological remission of AML due to sudden death. An autopsy was not performed. Conclusion: This clinical case highlights the emergence of Geotrichum capitatum as an opportunistic fungus in Italian leukemia patients. Moreover, our case report shows how liposomal amphotericin B could represent an effective therapeutic approach for these infections. Further studies are needed to shed more light on these rare fungal infections, in order to define the best therapeutic approach towards invasive geotrichosis. Keywords: geotrichum capitatum; fungemia; neutropenia; acute myeloid leukemia.