Invasive Geotrichum klebahnii fungal infection: A case report

Geotrichosis is a world-wide mycosis caused by Geotrichum species. We report a rare case of an invasive cutaneous infection by Geotrichum klebahnii in a female patient with undiagnosed diabetes mellitus. The patient presented with right facial swelling not responding to antibiotics and could not recall trauma to the site of the lesion. Histological examination showed fungal hyphae invading salivary glands and bony tissues, and G. klebahnii was isolated from the culture of biopsy material. Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (MS) confirmed the fungal species. Broth microdilution showed low minimum inhibitory concentrations (MICs) for itraconazole, posaconazole, voriconazole and amphotericin B. Treatment with sequential administration of intravenous amphotericin B with voriconazole followed by itraconazole led to the resolution of the lesion.