Catheter-Related Sepsis by Candida pararugosa in an Adult Patient under Chemotherapy Regimen

Candida pararugosa is present in animals and humans in different organs and biological liquids, usually as a saprophyte. We report the case of a 61-year-old woman diagnosed with de novo stage IV metastatic lobular breast cancer, carrying a central venous catheter (port-a-cath) and bilateral stents for perirenal infiltration by malignancy. During chemotherapy regimen, a febrile episode occurred, along with a high level of serum glucan. The port-a-cath was removed after blood collection for culture, which gave isolation of Candida pararugosa strains. Given high glucan level and the patient's frailty, empirical treatment with fluconazole was started with load-dose, 800 mg orally, at day 1 and, afterwards, with 400 mg daily for two weeks. The phenotype of susceptibility to antibiotics of the strain demonstrated lower minimal inhibitory concentration to fluconazole than that reported in the literature. The patient remained asymptomatic, and inflammation parameters showed normalization. Unfortunately, three weeks later, meningeal localization of cancer caused rapid deterioration and death.

[1]  C. Lass‐Flörl,et al.  Antifungal susceptibility profiles of rare ascomycetous yeasts. , 2019, The Journal of antimicrobial chemotherapy.

[2]  R. Schwan,et al.  Identification and characterization of yeasts from bovine rumen for potential use as probiotics , 2019, Journal of applied microbiology.

[3]  P. Chong,et al.  Antifungal susceptibilities, biofilms, phospholipase and proteinase activities in the Candida rugosa complex and Candida pararugosa isolated from tertiary teaching hospitals , 2019, Journal of medical microbiology.

[4]  A. Masotti,et al.  Phenotypic typing and epidemiological survey of antifungal resistance of Candida species detected in clinical samples of Italian patients in a 17 months' period. , 2018, Germs.

[5]  E. Palavecino,et al.  Candida pararugosa: First Reported Bloodstream Infection in an Adult , 2017, Cureus.

[6]  M. Nasri,et al.  Biosynthesis of single-cell biomass from olive mill wastewater by newly isolated yeasts , 2016, Environmental Science and Pollution Research.

[7]  Xianwei Yang,et al.  Molecular Identification of Candida Species Isolated from Onychomycosis in Shanghai, China , 2015, Mycopathologia.

[8]  J. Meis,et al.  Uncommon opportunistic yeast bloodstream infections from Qatar. , 2014, Medical mycology.

[9]  L. Ruiz,et al.  FUNGEMIA CAUSED BY Candida SPECIES IN A CHILDREN'S PUBLIC HOSPITAL IN THE CITY OF SÃO PAULO, BRAZIL: STUDY IN THE PERIOD 2007-2010 , 2014, Revista do Instituto de Medicina Tropical de Sao Paulo.

[10]  A. Colombo,et al.  Systematic review and new insights into the molecular characterization of the Candida rugosa species complex. , 2013, Fungal genetics and biology : FG & B.

[11]  Hongli Yuan,et al.  Detection and identification of wild yeast in Koumiss. , 2012, Food microbiology.

[12]  J. Guarro,et al.  Molecular Identification and Antifungal Susceptibility Testing of Clinical Isolates of the Candida rugosa Species Complex and Proposal of the New Species Candida neorugosa , 2012, Journal of Clinical Microbiology.

[13]  S. Jensen,et al.  Identification and characterization of Dekkera bruxellensis, Candida pararugosa, and Pichia guilliermondii isolated from commercial red wines. , 2009, Food microbiology.

[14]  G. Pizzo,et al.  Candida pararugosa isolation from the oral cavity of an Italian denture wearer. , 2004, Research in microbiology.

[15]  V. Robert,et al.  Recurrent isolation of an uncommon yeast, Candida pararugosa, from a sarcoma patient. , 2004, Medical mycology.

[16]  K. Komagata,et al.  Candida pararugosa, a new species of asporogenous yeast. , 1978 .