Geotrichum capitatum infection in a neutropenic patient. Case report and literature review.

Introduction. - Geotrichum capitatum sepsis are rare, occurring exclusively in immunocompromised patients. Exegesis. - We report the case of a patient with acute leukemia, presenting with chemotherapy-induced neutropenia and hospitalized in an intensive care unit for a severe sepsis. In spite of an antibiotic and antifungal treatment, the patient died of cardiorespiratory failure. Later on, blood cultures proved to be positive for Geotrichum capitatum. Conclusion. - If fungal infections are common in neutropenic patients, Geotrichum capitatum sepsis remain exceptional. The portal of entry is digestive or respiratory, and the invasion is favored by immunodepression and suppression of the normal microbial flora. Induced lesions can be multiorganic. The treatment is not well established, and the association of either amphotericine B and 5-fluorocytosine or amphotericine B and itraconazole would lead to better results. Nevertheless, the pronosis is still unfavorable, with a mortality rate of approximatively 75%. (C) 1998, Elsevier, Paris.