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Blastoschizomyces capitatus infection in patients with leukemia: report of 26 cases
Rodrigo Martino1, Miguel Salavert, Rocío Parody
1Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. rmartino@hsp.santpau.es
Abstract:
Twenty-six cases of Blastoschizomyces capitatus infection were diagnosed in 25 patients at 7 tertiary care hematology units in Spain over a 10-year period. Most patients (92%) had acute leukemia and developed infection during a period of severe and prolonged neutropenia. Two patients had esophagitis, and the rest had invasive infection. Fungemia (20 cases) was a common finding, with frequent visceral dissemination. The 30-day mortality associated with this infection was 52%, compared with 57% among patients with systemic infection. In a univariate analysis, the following 3 variables had a positive impact on 30-day survival: removal of the central venous catheter within 5 days after the onset of infection (P=.02), a good performance status (P=.003), and receipt of systemic prophylactic or empirical antifungal therapy before infection onset (P=.006). Outcome for neutropenic patients with B. capitatus infection is still poor. Rapid removal of the central venous catheter and novel antifungal therapies are recommended for treatment of this rare infection.
Insights
Blastoschizomyces capitatus infections are rare but serious, particularly in acute leukemia patients with neutropenia. Early central venous catheter removal and antifungal therapy improve survival, though outcomes remain poor.
Area of Science:
- Mycology
- Infectious Diseases
- Hematology
Background:
- Blastoschizomyces capitatus (B. capitatus) is an opportunistic fungal pathogen.
- Infections are rare but associated with significant morbidity and mortality, especially in immunocompromised individuals.
Purpose of the Study:
- To describe the clinical characteristics and outcomes of B. capitatus infections in patients treated at Spanish hematology units.
- To identify factors associated with survival in these patients.
Main Methods:
- Retrospective analysis of 26 cases of B. capitatus infection in 25 patients over a 10-year period.
- Data collected from 7 tertiary care hematology units in Spain.
- Univariate analysis to identify factors influencing 30-day survival.
Main Results:
- Most patients (92%) had acute leukemia and severe neutropenia.
- Invasive infection occurred in most cases, with fungemia and visceral dissemination being common.
- 30-day mortality was 52% for B. capitatus infection and 57% for systemic infection.
- Positive impact on survival: early central venous catheter removal, good performance status, and prior antifungal therapy.
Conclusions:
- Outcomes for neutropenic patients with B. capitatus infection remain poor.
- Recommendations include prompt central venous catheter removal and consideration of novel antifungal therapies.
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