Geotrichum candidum as an Opportunistic Human Pathogen in Cancer Patients and Benign Conditions

Geotrichosis caused by Geotrichum candidum (G. candidum) is a rarely reported opportunistic infection. Immunocompromised hosts are particularly susceptible to this fungal strain. To shed more light on this opportunistic pathogen and its significance in human disease, we analyzed publicly available data and discussed potential therapies for this fungal strain.

A systematic online search was conducted, and suitable case reports were retrieved for subsequent retrospective analysis. We eventually selected data on 22 cases for final analysis according to the PRISMA guidelines. To summarize the demographic and clinical variables, descriptive statistical measures were applied. Besides, we contributed one additional case of a leukemia patient with catastrophic G. candidum sepsis from our institution to the data pool.

G. candidum mycosis is frequently deadly for patients with cancer. Leukopenia contributes to higher mortality rates in this vulnerable population. Cancer itself as well as hematological malignancies are more common among non-survivors in this explorative analysis [patients with cancer (n=11) vs. others (n=12), p<0.01; blood cancer (n=8) vs. others (n=15), p<0.05]. We did not detect a consistent association regarding differences in the choice of antifungal compounds for treatment (e.g., amphotericin B/liposomal amphotericin B vs. others) or whether monotherapy or sequential therapy was administered. One patient with acute myeloid leukemia from our center eventually died due to a mixed fungal pneumonia including G. candidum despite broad antifungal treatment.

Although deemed a yeast of low virulence, G. candidum can turn into a deadly germ for immunocompromised hosts. Leukopenia probably aggravates the course of the disease in these patients.