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@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.
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