GEOTRICHOSIS OF ORAL-MUCOSA

A livid, sharply defined enanthema of the oral mucosa with ulcerations on the soft palate in a patient presenting with de novo acute myeloid leukaemia with prolonged, therapy-induced granulocytopenia (<0.5 nl(- 1) for 113 days!) was diagnosed as geotrichosis. Geotrichum capitatum was identified both in vivo and in vitro. Pneumonic infiltrates in the upper lobes of both lungs were treated with amphotericin B infusions. Healing of the aforementioned enanthema was only achieved after addit ion of 5-fluorocytosine to therapy. Susceptibility determinations with several Geotrichum capitatum isolates led to the conclusion that amph otericin B was unsuitable as a therapeutic agent in this case. 5-Fluor cytosine and intraconazole exhibited superior antifungal and antimycot ic activity.