Immune reconstitution inflammatory syndrome following allo-SCT in a patient with Dipodascus capitatus spondylodiscitis.

摘要

We describe a man with allogeneic BMT who developed Dipodascus capitatus (anamorph Geotrichum capitatuni) spondylodiscitis. Relapse of the bone and joint lesions remained culture negative and paralleled the immune restitution, suggesting an immune reconstitution inflammatory syndrome (IRIS).A 48-year-old patient was diagnosed with AML. During induction chemotherapy (daunorubicin, cytarabine and etoposide) and consolidation cycle he received antifungal prophylaxis with oral posaconazole (200mg/8h). In May 2008, he underwent allogeneic related HLA-matched BMT after myeloablative conditioning with BU and CY. GVHD prophylaxis with CYA was adjusted to the 250ng/ml blood level. On day 2 of neutropenia, he developed fever and grade IV mucositis. Four blood cultures yielded D. capitatus.