Rare multi-fungal sepsis: a case of triple-impact
immunoparalysis

J 2024

Rare multi-fungal sepsis: a case of triple-impact immunoparalysis

LIPOVÝ, Břetislav, Martin HLADÍK, Kateřina VYKLICKÁ, Iva KOCMANOVÁ, Martina LENGEROVÁ et. al.

Basic information

Original name

Rare multi-fungal sepsis: a case of triple-impact immunoparalysis

Authors

LIPOVÝ, Břetislav (203 Czech Republic, belonging to the institution), Martin HLADÍK (703 Slovakia, belonging to the institution), Kateřina VYKLICKÁ (203 Czech Republic, belonging to the institution), Iva KOCMANOVÁ (203 Czech Republic), Martina LENGEROVÁ (203 Czech Republic, belonging to the institution), Leoš KŘEN (203 Czech Republic, belonging to the institution), Michal SRNÍK (203 Czech Republic, belonging to the institution), Jan BÖHM (203 Czech Republic, belonging to the institution), Petr ANDRLA (203 Czech Republic, belonging to the institution) and Petra BOŘILOVÁ LINHARTOVÁ (203 Czech Republic, guarantor, belonging to the institution)

Edition

Folia microbiologica, Praha, Mikrobiologický ústav Praha AV ČR, 2024, 0015-5632

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30405 Medical biotechnology related ethics

Country of publisher

Netherlands

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 2.600 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1007/s12223-024-01165-0

UT WoS

001206029000001

Keywords in English

Mycobiome; COVID-19; Isavuconazole; Inhalation injury

Abstract

V originále

Patients with burn injury and inhalation injury are highly susceptible to infectious complications, including opportunistic pathogens, due to the loss of skin cover and mucosal damage of respiratory tract as well as the disruption of homeostasis. This case report, a 34-year-old man suffered critical burns, provides the first literature description of triple-impact immunoparalysis (critical burns, inhalation injury, and SARS-CoV-2 infection), leading to a lethal multifocal infection caused by several fungi including very rare environmental representatives Metschnikowia pulcherrima and Wickerhamomyces anomalus. The co-infection by these common environmental yeasts in a human is unique and has not yet been described in the literature. Importantly, our patient developed refractory septic shock and died despite targeted antifungal therapy including the most potent current antifungal agent-isavuconazole. It can be assumed that besides immunoparalysis, effectiveness of therapy by isavuconazole was impaired by the large distribution volume in this case. As this is a common situation in intensive care patients, routine monitoring of plasmatic concentration of isavuconazole can be helpful in personalization of the treatment and dose optimization. Whatmore, many fungal species often remain underdiagnosed during infectious complications, which could be prevented by implementation of new methods, such as next-generation sequencing, into clinical practice.

Links

LM2018132, research and development project

Name: Národní centrum lékařské genomiky (Acronym: NCLG)

Investor: Ministry of Education, Youth and Sports of the CR, National Center for Medical Genomics

LM2023069, research and development project

Name: Výzkumná infrastruktura RECETOX

Investor: Ministry of Education, Youth and Sports of the CR, RECETOX research infrastructure

Citovat

LIPOVÝ, Břetislav, Martin HLADÍK, Kateřina VYKLICKÁ, Iva KOCMANOVÁ, Martina LENGEROVÁ, Leoš KŘEN, Michal SRNÍK, Jan BÖHM, Petr ANDRLA and Petra BOŘILOVÁ LINHARTOVÁ. Rare multi-fungal sepsis: a case of triple-impact immunoparalysis. Folia microbiologica. Praha: Mikrobiologický ústav Praha AV ČR, 2024, vol. 69, No 4, p. 903-911. ISSN 0015-5632. Available from: https://dx.doi.org/10.1007/s12223-024-01165-0.

@article{2423021,
   author = {Lipový, Břetislav and Hladík, Martin and Vyklická, Kateřina and Kocmanová, Iva and Lengerová, Martina and Křen, Leoš and Srník, Michal and Böhm, Jan and Andrla, Petr and Bořilová Linhartová, Petra},
   article_location = {Praha},
   article_number = {4},
   doi = {http://dx.doi.org/10.1007/s12223-024-01165-0},
   keywords = {Mycobiome; COVID-19; Isavuconazole; Inhalation injury},
   language = {eng},
   issn = {0015-5632},
   journal = {Folia microbiologica},
   title = {Rare multi-fungal sepsis: a case of triple-impact immunoparalysis},
   url = {https://link.springer.com/article/10.1007/s12223-024-01165-0},
   volume = {69},
   year = {2024}
}

TY  - JOUR
ID  - 2423021
AU  - Lipový, Břetislav - Hladík, Martin - Vyklická, Kateřina - Kocmanová, Iva - Lengerová, Martina - Křen, Leoš - Srník, Michal - Böhm, Jan - Andrla, Petr - Bořilová Linhartová, Petra
PY  - 2024
TI  - Rare multi-fungal sepsis: a case of triple-impact immunoparalysis
JF  - Folia microbiologica
VL  - 69
IS  - 4
SP  - 903-911
EP  - 903-911
PB  - Mikrobiologický ústav Praha AV ČR
SN  - 00155632
KW  - Mycobiome
KW  - COVID-19
KW  - Isavuconazole
KW  - Inhalation injury
UR  - https://link.springer.com/article/10.1007/s12223-024-01165-0
N2  - Patients with burn injury and inhalation injury are highly susceptible to infectious complications, including opportunistic pathogens, due to the loss of skin cover and mucosal damage of respiratory tract as well as the disruption of homeostasis. This case report, a 34-year-old man suffered critical burns, provides the first literature description of triple-impact immunoparalysis (critical burns, inhalation injury, and SARS-CoV-2 infection), leading to a lethal multifocal infection caused by several fungi including very rare environmental representatives Metschnikowia pulcherrima and Wickerhamomyces anomalus. The co-infection by these common environmental yeasts in a human is unique and has not yet been described in the literature. Importantly, our patient developed refractory septic shock and died despite targeted antifungal therapy including the most potent current antifungal agent-isavuconazole. It can be assumed that besides immunoparalysis, effectiveness of therapy by isavuconazole was impaired by the large distribution volume in this case. As this is a common situation in intensive care patients, routine monitoring of plasmatic concentration of isavuconazole can be helpful in personalization of the treatment and dose optimization. Whatmore, many fungal species often remain underdiagnosed during infectious complications, which could be prevented by implementation of new methods, such as next-generation sequencing, into clinical practice.
ER  -

LIPOVÝ, Břetislav, Martin HLADÍK, Kateřina VYKLICKÁ, Iva KOCMANOVÁ, Martina LENGEROVÁ, Leoš KŘEN, Michal SRNÍK, Jan BÖHM, Petr ANDRLA and Petra BOŘILOVÁ LINHARTOVÁ. Rare multi-fungal sepsis: a case of triple-impact immunoparalysis. \textit{Folia microbiologica}. Praha: Mikrobiologický ústav Praha AV ČR, 2024, vol.~69, No~4, p.~903-911. ISSN~0015-5632. Available from: https://dx.doi.org/10.1007/s12223-024-01165-0.

Detailed Information on Publication Record