# Disseminated Saprochaete capitata Fungemia in Acute Myeloid Leukemia: A Case Report and Literature Review From the United Arab Emirates

## TL;DR

A rare case of Saprochaete capitata infection in a leukemia patient in the UAE highlights the challenges in diagnosis and treatment of this deadly fungus.

## Contribution

This case report provides insights into the clinical presentation, antifungal resistance, and management challenges of S. capitata in immunocompromised patients.

## Key findings

- S. capitata isolate showed resistance to fluconazole and echinocandins but susceptibility to amphotericin B and voriconazole.
- Disseminated infection with pulmonary and hepatic involvement was observed despite aggressive antifungal therapy.
- The patient's persistent fungemia and multi-organ failure led to mortality, emphasizing the high risk of S. capitata infections.

## Abstract

Saprochaete capitata (formerly Geotrichum capitatum) is a rare fungal pathogen that predominantly affects immunocompromised individuals, particularly those with hematologic malignancies and prolonged neutropenia. We report a rare case of S. capitata fungemia in a 49-year-old male newly diagnosed with acute myeloid leukemia (AML), managed in the United Arab Emirates. Despite prophylactic fluconazole during induction chemotherapy, the patient developed persistent febrile neutropenia. Blood cultures drawn from a peripherally inserted central catheter (PICC) grew yeast, later identified as S. capitata via biochemical profiling and carbohydrate assimilation testing. The isolate was resistant to fluconazole and echinocandins but susceptible to amphotericin B and voriconazole. Combination antifungal therapy with liposomal amphotericin B and voriconazole was initiated, and the PICC line was removed. Follow-up imaging revealed pulmonary consolidation and multiple hypodense lesions in the liver and spleen, consistent with disseminated fungal infection. Despite aggressive antifungal management, the patient developed persistent fungemia, multi-organ failure, and died on hospital day 81. This case underscores the diagnostic complexity, intrinsic antifungal resistance, and high mortality associated with S. capitata, and highlights the need for early species identification, tailored antifungal therapy, and improved fungal diagnostics in the region.