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Septic shock induced by Lecythophora mutabilis in a patient with mitochondrial encephalomyopathy

Yuki Taniguchi1, Takeshi Taketani2,3, Hidehiko Moriyama1

  • 1Central Clinical Laboratory, Shimane University Hospital, Shimane, Japan.

Journal of Medical Microbiology
|June 17, 2009
PubMed

Insights

Invasive fungal infections (IFIs) caused by Lecythophora mutabilis in immunocompromised patients may present with eosinophilia. Beta-d-glucan assays may be unreliable, and echinocandin antifungals may be ineffective.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Invasive fungal infections (IFIs) pose a significant threat to immunocompromised individuals.
  • Lecythophora mutabilis is an opportunistic fungal pathogen.
  • Mitochondrial encephalomyopathy, refractory anemia, and chronic renal failure represent severe comorbidities impacting host immunity.

Observation:

  • An 18-year-old male patient with multiple comorbidities presented with septic shock.
  • Lecythophora mutabilis was identified as the causative agent through blood culture, morphology, and genetic analysis.
  • The patient exhibited eosinophilia during the infection, while beta-d-glucan levels remained normal.

Findings:

  • Despite treatment with micafungin and liposomal amphotericin B, the patient's condition deteriorated, leading to death.
  • Eosinophilia was observed in this case of L. mutabilis infection, contrary to typical fungal infection markers.
  • Normal beta-d-glucan levels suggest limitations in its diagnostic utility for L. mutabilis IFIs.

Implications:

  • Clinicians should consider L. mutabilis as a potential cause of IFI in compromised hosts presenting with eosinophilia.
  • Antifungal therapies targeting beta-d-glucan, such as echinocandins, may not be effective against L. mutabilis.
  • Further research is needed to understand the pathogenesis and optimal treatment strategies for L. mutabilis infections.

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