Geotrichosis: fungemia in a patient with acute lymphoblastic leukemia: case report

Fungemia due to Geotrichum spp is rare and highly lethal. An example is that only one case was reported between 2.012 and 2.018 at the National Cancer Institute in Bogota. This type of infection is more common in patients with some degree of compromise of the immune system, so it can occur in patients with hematological malignancies. In the next article is presented the case of a 27-year-old man, diagnosed with acute lymphoblastic leukemia in relapse, who was admitted due to polyarthralgia lasting five days. Associated with febrile neutropenia, non-abscessed cellulitis, and bacteremia due to methicillin-sensitive Staphylococcus aureus. Therefore, the patient received therapy with oxacillin and cefepime, however, febrile neutropenia persisted. Consequently, a new set of blood cultures was taken and antifungal treatment was started, because of the suspicion of invasive fungal infection (IFI). Arthroconidia were identified in blood cultures and Geotrichum spp. was confirmed by proteomics (MALDI-TOF), antifungal treatment was adjusted with amphotericin B deoxycholate for 14 days and voriconazole for 4 weeks, and after a prolonged stay the patient was discharged alive. Although the incidence of fungemia due to Geotrichum spp is low, in patients with hematological malignancies it should be considered in the context of persistent febrile neutropenia despite broad-spectrum antimicrobial treatment. The confirmation of a fungemia with tools such as MALDI TOF allows targeted treatment to be adjusted, decreasing the complications, hospitalization and mortality