Multiple Hepatic Microabscesses Caused by Magnusiomyces Clavatus in a Patient With Acute Myeloid Leukemia: A Case Report

Document Type

Conference Proceeding

Publication Date

11-2023

Publication Title

American Journal of Clinical Pathology

Abstract

Introduction/Objective

Invasive fungal infections can result in significant complications for acute myeloid leukemia (AML) patients undergoing induction chemotherapy. While Candida and Aspergillus are the most common fungal pathogens, Magnusiomyces clavatus (Geotrichum clavatum) is a rare fungal pathogen that has been reported to cause invasive infection in immunocompromised patients. Here, we report a case of fungemia and hepatic microabscess with Magnusiomyces clavatus in an 18-year-old female with AML. Methods/Case Report

An 18-year-old female with AML in remission after induction chemotherapy presented with fevers. Further work-up revealed fungemia on her blood culture. While awaiting culture speciation, numerous hepatic lesions were identified on the abdominal CT scan, which were biopsied. The liver biopsy showed aggregates of fungi with septate hyphae on silver-stained sections. The initial morphologic differential diagnosis included Aspergillus and Mucormycosis. Her blood cultures ultimately revealed fungemia with Magnusiomyces clavatus (Geotrichum clavatum), a yeast that is rising in prevalence, particularly among neutropenic and leukemic patients. The morphology of fungi detected in the liver biopsy resembled Magnusiomyces clavatus and a subsequent PCR testing confirmed that the fungi present was Magnusiomyces clavatus. She was started on voriconazole and liposomal amphotericin B. She became afebrile with no growth on blood cultures for several days and was discharged to outpatient follow-up. Results (if a Case Study enter NA)

N/A Conclusion

This case highlights the clinical significance of Magnusiomyces clavatus in immunocompromised patients, particularly those with AML, and emphasizes the importance of considering rare fungal pathogens in such patients who present with fever. Treatment with voriconazole and liposomal amphotericin B can be helpful in relieving symptoms.

Volume

160

Issue

Suppl 1

First Page

S86

Comments

American Society of Clinical Pathology ASCP Annual Meeting, October 18-20, 2023, Long Beach, CA

Last Page

S87

DOI

10.1093/ajcp/aqad150.192

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