Review Articles

Magnusiomyces capitatus Breakthrough Infection in Allogeneic Hematopoietic Cell Transplant Recipients Receiving Echinocandin Prophylaxis: Clinical Features, Management, and Structured Review of the Literature

Claudia Gómez-Hernández1, Carmen Corrales2, Pedro José Mirete1, Soraya Ramos1, Mireia Micó-Cerdà1, Clara Isabel Martínez-López1, Juan Carlos Hernández-Boluda1,3, Carlos Solano1,3,4, Rafael de la Camara2 and José Luis Piñana1,3.

1 Hematology Department, Hospital Clinico Universitario of Valencia, Spain.

2 Hematology Department, Hospital de la Princesa, Madrid, Spain.

3 INCLIVA, biomedical research institute, Valencia, Spain.

4 Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain.

Supplementary Files

Table S1. Detailed baseline, transplant, infection, treatment, and outcome data for all 13 patients with invasive Magnusiomyces infection after allogeneic HSCT (combines Tables 1A and 1B with additional case-level detail).

Variable123456789101112*13*
Reference (author, year)Rodrigo Martino et al., 2004 [8]González-Abad et al., 2012 [9]S.K. Devadas et al., 2015 [10]Dominika Tanuskova et al., 2017 [11]Shuki Oya et al., 2018 [12]M. Leoni et al., 2019 [13]Giuliana Lo Cascio et al., 2020 [14]Julio Maquera-Afaray et al., 2022 [15]Rinaldi A et al., 2022 [16]Rochelle Johnstone et al., 2022 [17]Rahmah S. Alzahrani et al., 2025 [18]Present study, Case 1, 2025Present study, Case 2, 2025
CountrySpainSpainIndiaSlovakiaJapanItalyItalyPeruItalyCanadaCanadaSpainSpain
Age / sex

37 y / M

9 y / M

33 y / M

19 y / F

68 y / M

6 y / M

60 y / M

5 y / M

61 y / M

39 y / M

69 y / M

57 y / M

67 y / M

Underlying hematologic diseaseALLAAAMLMDSALLAAAMLAAAMLAMLPMFAMLPMF
Donor type (HLA match)NRMUD (10/10)MRD (10/10)MUD (9/10)UCBHaploidenticalNRHaploidenticalMUD (10/10)HaploidenticalMRD (10/10)HaploidenticalMUD (10/10)
Conditioning regimenNRNRMACMACRICRICNRRICRICNRRICMACRIC
GVHD prophylaxisNRNRCsA + MTXATG + CsA + MTXTAC + MTXNRNRNRATG + CsA + MTXNRTAC + MMFSIR + MMF + PTCySIR + MMF + PTCy
Stem cell sourcePBBMNRPBUCBPBNRBMPBNRPBPBPB
Antifungal prophylaxisFLCNRPOSMCFGMCFGL-AmBPOSPOSPOSCASFLCMCFGMCFG
Fungal speciesB. capitatusB. capitatusB. capitatusM. capitatusG. capitatumM. clavatusS. clavataS. capitataG. ClavatumB. capitatusM. clavatusM. capitatusM. spp
Clinical presentationFNFNSkin/soft-tissue nodulesFNFNFNFNFNFNFNFNFNFN
Deep-organ involvementYes†YesNoYesYesYesNoYesYesYesYesYesYes
ANC at infection onset

0 ×10⁹/L

NRNR

0 ×10⁹/L

0 ×10⁹/L

0 ×10⁹/L

NR

0 ×10⁹/L

0 ×10⁹/L

NR

0 ×10⁹/L

0 ×10⁹/L

0 ×10⁹/L

Neutrophil engraftment achieved (day)NRNRNRYes (+10 d)NoYes (+10 d)NRNoYes (+17 d)NRNoNoNo
Granulocyte transfusion (day)NRNoNRYes (+10 d)NoNRNRNoNRNoYes (+20 d)NoNo
Site of isolationBlood cultureBlood cultureSkin/soft-tissue biopsyBlood cultureBlood cultureBlood cultureBlood cultureBlood cultureBlood culture + CSFBlood cultureBlood cultureBlood cultureBlood culture
Day of infection post-HSCTNRNR>Day +180 (>6 mo)Day +3Day +11Day +2Day +5Day +147NRDay +5Day +13Day +21Day +23
CVC/PICC removedNoYesNRYesNRYesNRNoNRNRYesYesYes
Galactomannan (GM) assayNRNRNRNRNRNRNRNegativeNRNRNRNegativeNegative
β-D-glucan (BDG) assayNRNRNRNRPositiveNRNRNRNRNRNRPositivePositive
Antifungal treatmentL-AmBL-AmB + POSVRCMCFG + VRCL-AmB + FLCL-AmB + VRCL-AmBCASL-AmB + ISAVRC + L-AmBVRC + L-AmBPOS + AmB‡POS + L-AmB
Other concurrent infectionsNoYesNoYesYesNoNoNoNoNoYesNoYes
OutcomeAliveDeath (+90 d)AliveDeath (+71 d)Death (+25 d)AliveAliveDeath (+150 d)Death (+17 d)Death (+13 d)Death (+22 d)Death (+24 d)Death (+45 d)
Cause of deathSeptic shockMultiorgan failureRespiratory failureSeptic shockSevere neurological damageIntracerebral hemorrhageSeptic shockMultiorgan failureSeptic shock

* Present study cases (columns 12 and 13; shaded), reported here for the first time. All other cases (columns 1–11) are from the previously published literature cited in the reference row. NR: not reported in the source publication; –: not applicable. Abbreviations: AA, aplastic anemia; ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; ANC, absolute neutrophil count; ATG, antithymocyte globulin; BDG, beta-D-glucan; BM, bone marrow; CAS, caspofungin; CsA, cyclosporine A; CSF, cerebrospinal fluid; CVC, central venous catheter; F, female; FLC, fluconazole; FN, febrile neutropenia; GM, galactomannan; GVHD, graft-versus-host disease; HLA, human leukocyte antigen; HSCT, hematopoietic stem cell transplantation; ISA, isavuconazole; L-AmB, liposomal amphotericin B; M, male; MAC, myeloablative conditioning; MCFG, micafungin; MDS, myelodysplastic syndrome; MMF, mycophenolate mofetil; MRD, matched related donor; MTX, methotrexate; MUD, matched unrelated donor; NR, not reported; PB, peripheral blood; PICC, peripherally inserted central catheter; PMF, primary myelofibrosis; POS, posaconazole; PTCy, post-transplant cyclophosphamide; RIC, reduced-intensity conditioning; SIR, sirolimus; TAC, tacrolimus; UCB, umbilical cord blood; VRC, voriconazole. B, Blastoschizomyces; M., Magnusiomyces; G, Geotrichum; S, Saprochaete. Notes on standardization applied. Taxonomy: the causative genus is reported uniformly as Magnusiomyces (current accepted name; historical synonyms in the cited literature include Geotrichum capitatum/clavatum, Blastoschizomyces capitatus, and Saprochaete capitata/clavata). Species-level identification (M. capitatus vs. M. clavatus) was not consistently reported across the reviewed sources; we could confirm M. clavatus for the Leoni et al. 2019 and Alzahrani et al. 2025 cases from the original publications.