García-Ruiz Juan Carlos, López-Soria Leyre, Olazábal Iñigo, Amutio Elena, Arrieta-Aguirre Inés, Velasco-Benito Verónica, Pontón Jose, Moragues Maria-Dolores
Servicio de Hematología y Hemoterapia, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain.
Rev Iberoam Micol. 2013 Oct-Dec;30(4):248-55. doi: 10.1016/j.riam.2013.02.004. Epub 2013 Apr 11.
Saprochaete capitata (formerly known as Geotrichum capitatum and Blastoschizomyces capitatus) is a ubiquitous fungus found in soil, water, air, plants and dairy products. It colonizes the skin, and bronchial and intestinal tract of healthy people producing serious opportunistic infections in patients with haematological malignancies, especially in those with acute leukaemia. Since 1960s its presence is being increasingly recognized in this group of patients. The clinical spectrum of S. capitata disseminated infections is very similar to that produced by Candida, being easily misinterpreted. The associated high mortality and low susceptibility to fluconazole and echinocandins of S. capitata require the acknowledgement of this emergent infection so that it can be properly treated.
We report 5 new cases of S. capitata disseminated infection in patients with advanced haematological malignancies observed in the haematology unit between the years 2004 and 2010, and review the state-of-the-art for diagnosis and treatment of this infection.
Based on our experience, the prophylactic use of or the empirical antifungal treatment with fluconazole and/or echinocandins would not be adequate for oncohaematological patients in those hospitals where S. capitata infection may be highly prevalent.
头状腐质霉（以前称为头状地霉和头状芽裂酵母）是一种广泛存在于土壤、水、空气、植物和乳制品中的真菌。它可定植于健康人的皮肤、支气管和肠道，在血液系统恶性肿瘤患者，尤其是急性白血病患者中引发严重的机会性感染。自20世纪60年代以来，其在这类患者中的存在越来越受到认可。头状腐质霉播散性感染的临床谱与念珠菌所致感染非常相似，容易被误诊。头状腐质霉相关的高死亡率以及对氟康唑和棘白菌素的低敏感性，需要人们认识到这种新出现的感染，以便能够进行恰当治疗。
我们报告了2004年至2010年间在血液科观察到的5例晚期血液系统恶性肿瘤患者发生头状腐质霉播散性感染的新病例，并回顾了这种感染的诊断和治疗现状。
根据我们的经验，在头状腐质霉感染可能高度流行的医院，对于肿瘤血液病患者，预防性使用氟康唑和/或棘白菌素进行经验性抗真菌治疗并不充分。
