Catheter-related infection due to Papiliotrema laurentii in an oncologic patient: Case report and systematic review

• Published in: The Brazilian journal of infectious diseases Vol. 23; no. 6; pp. 451 - 461
• Main Authors: Londero, Marcos Rech, Zanrosso, Crisley Dossin, Corso, Leandro Luis, Michelin, Lessandra, Soldera, Jonathan
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier España, S.L.U 01.11.2019; Contexto; Elsevier; Brazilian Society of Infectious Diseases
• Subjects: Aged; Amphotericin B; Amphotericin B - therapeutic use; Analysis; Anti-Bacterial Agents - therapeutic use; Antiparasitic agents; Bacteremia - microbiology; Biopsy; Cancer; Cancer patients; Case Report; Catheter-related infections; Catheter-Related Infections - diagnostic imaging; Catheter-Related Infections - drug therapy; Catheter-Related Infections - etiology; Catheter-Related Infections - microbiology; Catheterization; Comorbidity; Cryptococcus; Cryptococcus - isolation & purification; Female; Fluconazole - therapeutic use; Health; Health aspects; Humans; Infection; INFECTIOUS DISEASES; Medical research; Papiliotrema; Piperacillin, Tazobactam Drug Combination - therapeutic use; Stomach neoplasms; Stomach Neoplasms - diagnostic imaging; Stomach Neoplasms - microbiology; Stomach Neoplasms - therapy; Tomography, X-Ray Computed; Tumors; Vancomycin - therapeutic use; Women; Cryptococcus; Amphotericin B; Catheter-related infections; Papiliotrema; Stomach neoplasms
• ISSN: 1413-8670; 1678-4391; 1678-4391
• DOI: 10.1016/j.bjid.2019.10.005

Papiliotrema laurentii is one of several non-neoformans cryptococci that have rarely been associated with human infection, since it was previously considered saprophyte and thought to be non-pathogenic to humans. Nevertheless, increasing number of reports of human infection have emerged in recent years, mostly in oncologic patients. To report a case of a female patient with pyloric obstructive cancer with a catheter-related Papiliotrema laurentii blood stream infection and systematically review the available evidence on P. laurentii infection in humans. Retrieval of studies was based on Medical Subject Headings and Health Sciences Descriptors, which were combined using Boolean operators. Searches were run on the electronic databases Scopus, Web of Science, MEDLINE (PubMed), BIREME (Biblioteca Regional de Medicina), LILACS (Latin American and Caribbean Health Sciences Literature), Cochrane Library for Systematic Reviews and Opengray.eu. There was no language or date of publication restrictions. The reference lists of the studies retrieved were searched manually. The search strategy retrieved 1703 references. In the final analysis, 31 references were included, with the description of 35 cases. Every patient but one had a previous co-morbidity - 48.4 % of patients had a neoplasm. Amphotericin B was the most used treatment and only a single case of resistance to it was reported. Most patients were cured of the infection. P. laurentii infection in humans is usually associated to neoplasia and multiple co-morbidities, and amphotericin B seems to be a reliable agent for treatment.