Saprochaete clavata (Geotrichum clavatum) septicemia in a patient with multiple myeloma; An emerging case from Southeastern Turkey

Handan  Kangul; Nida  Ozcan; Nurullah   Uzuner; Mahmut  Mete; Ufuk   Mert Erginer

doi:10.18502/cmm.6.4.5440

Handan Kangul Department of Medical Microbiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
Nida Ozcan Department of Medical Microbiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
Nurullah Uzuner Department of Medical Microbiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
Mahmut Mete Department of Medical Microbiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
Ufuk Mert Erginer Department of Internal Medicine, Faculty of Medicine, Dicle University, Diyarbakır, Turkey

DOI: https://doi.org/10.18502/cmm.6.4.5440

Keywords: Geotrichum clavatum Invasive fungal infection Multiple myeloma Saprochaete clavata

Abstract

Background and Purpose: Invasive fungal infections (IFI) are life-threatening and can be seen in immuno-compromised patients with malignancy, those who undergo chemotherapy, or transplant recipients. The Candida and Aspergillus species are the most common IFI agents; however, infections can also be caused by rare fungal species. This case report is about a bloodstream infection due to Saprochaete clavata (formerly known as Geotrichum clavatum) in a woman with multiple myeloma.

Case report: A 59-years-old woman suffered from fever, widespread rashes, and diarrhea after an autologous bone marrow transplantation. Peripheral blood cultures were taken from the patient and sent to the microbiology laboratory. Cultures grew white to cream-colored cottony colonies. Moreover, septate and branched hyphae and arthroconidia were seen under a microscope by lactophenol blue staining. The fungi colonies were identified by Maldi Biotyper 3. 1. (manufactured by Bruker Daltonics, USA) as S. clavata (G. clavatum) with a reliable score. Antifungal susceptibility test was carried out by the concentration gradient strip Etest method. Minimal inhibitory concentrations of Amphotericin B, fluconazole, voriconazole, posaconazole, and anidulafungin were determined as 4, 3, 0.125, 0.125, and > 32 mg/dL, respectively. Despite amphotericin B treatment, the patient died three days after the identification of the fungi.

Conclusion: The IFIs are serious conditions that have high mortality rates. In the current case report, we aimed to draw attention to S. clavata which is a rare fungal agent.