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Three Cases of Catheter-related Bloodstream Infection Caused by Phialemonium curvata : A Case Report and Literature
Seval Özen1, Nilgün Karabiçak2, Sema Turan Uzuntaş3
1From the Department of Pediatric Infectious Diseases, Ankara Bilkent City Hospital, Ankara, Turkey.
Background:
With recent developments in the field of microbiology, an increasing number of yeasts and molds with the potential to cause infections in humans are identified every year. In addition to the challenges in identifying clinical isolates, there is limited antifungal susceptibility data available for Phialemonium species, leading to uncertainty in optimal treatment recommendations.
Methods:
In this article, catheter-related bloodstream infections caused by Phialemonium curvata (previously Phialemonium curvatum ) in 3 immunosuppressed patients are presented. Furthermore, the literature was reviewed to identify the clinical spectrum and treatment approaches for the reported infections.
Results:
The cases presented here were analyzed along with 24 cases reported in the literature. Among all cases, 21 (77.7%) patients had an underlying condition. Nine (33.3%) patients had hematologic/oncologic malignancies and solid organ transplants. Twenty-two (81.4%) patients had a history of device or invasive interventions. Surgical procedures, removal of contaminated devices or tissue were found to reduce the risk of death by 86.7%. Correspondence analysis revealed a significant association between antifungal treatment and outcome ( P < 0.001). The correspondence analysis could explain 53.9% of this relationship. Monotherapy and combination therapy were associated with survival. While salvage treatment or no antifungal therapy was associated with mortality, intravitreal injection or topical application of voriconazole was associated with sequelae.
Conclusions:
Surgical intervention and removal of contaminated devices or tissue should be considered at an early stage.
Insights
Early surgical intervention and device removal are crucial for treating Phialemonium curvata infections in immunocompromised patients. Antifungal therapy and surgical procedures significantly improve outcomes, reducing mortality risk.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Emerging yeasts and molds pose increasing human infection risks.
- Phialemonium species present diagnostic and treatment challenges due to limited antifungal data.
- Catheter-related bloodstream infections (CRBSIs) are a concern in vulnerable populations.
Purpose of the Study:
- To present cases of CRBSI caused by Phialemonium curvata in immunosuppressed patients.
- To review the clinical spectrum and treatment of Phialemonium infections.
- To identify factors influencing outcomes in Phialemonium infections.
Main Methods:
- Case series of 3 patients with Phialemonium curvata CRBSI.
- Comprehensive literature review of 24 additional cases.
- Statistical analysis including correspondence analysis to assess treatment impact.
Main Results:
- Most patients (77.7%) had underlying conditions, including malignancies and transplants.
- Invasive interventions (81.4%) were common. Surgical procedures and device removal reduced mortality by 86.7%.
- Antifungal treatment showed a significant association with survival (P < 0.001).
Conclusions:
- Early surgical intervention and removal of contaminated devices/tissue are vital.
- Both monotherapy and combination antifungal therapy are associated with survival.
- Prompt management improves patient outcomes in Phialemonium infections.
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