An unusual case of Candida ciferrii fungemia in an immunocompromised patient with Crohn’s and Mycobacterium bovis disease

Abstract

We present a case report of a fungal bloodstream infection due to an unusual pathogen. This is a 30 years-old female patient diagnosed with Crohn's disease and a disseminated Mycobacterium bovis infection subsequently complicated by fungemia due to the emergent yeast pathogen Candida ciferrii, who was unresponsive to fluconazole and made a full recovery after treatment with posaconazole. To our knowledge, this is the first report of Candida ciferrii isolation from blood in an adult associated to a central venous catheter and which was successfully treated with posaconazole.

A rare case of blood stream infection due to Candida ciferii in an immuno-compromised patient

“…ciferrii is an unusual species of Candida, which has been rarely reported as a cause of human infection mostly in patients with immunosuppression. [1][2][3]5,6 . Most of the reported C. ciferrii cases include malignant otitis externa and onychomycosis.…”

“…Finally, it was necessary to use posaconazole, a broadspectrum drug, to treat this patient. 11 De Gentile L et al, report six cases of toe-nail onyxis due to an unusual yeast species, Candida ciferrii. 12 Capoor et al, reported C. ciferrii in AML patient.…”

“…1,2 Fungal infections have increased morbidity and mortality and prolonged hospital stay which can lead to rise in medical care costs. 3 Non-albicans Candida species have been increasingly found as causative agents in human infections with important therapeutic implications. 4 The unusual yeast species Candida ciferrii, was first described in 1965, and it was named in honor of memory of Prof. Dr. R. CIFERRI.…”

“…1 C. ciferrii is an unusual species of Candida, which has been rarely reported as a cause of human infection mostly in patients with immune suppression. [1][2][3]5,6 She was started on Induction Chemotherapy with following drugs-Vincristine, Prednisolone, Daunomycin, L-asparaginase and intrathecal methotrexate. Following induction chemotherapy, her WBC counts stared reducing upto 2230/cu.mm.…”

Antifungal Resistance of Candida Species in Bacolod City, Philippines

“…With the current available literatures, C. ciferrii is rarely isolated or an infrequent type of Candida species that is known to cause superficial pathogenicity [29][30][31]. Some papers have documented that C. ciferrii was able to cause blood stream infections [29][30][31], pulmonary infections [30,32], gangrenous infections [30], onchomycosis [33] and urinary tract infections [14]. Similarities among these infected patients include co-morbidities such as COPD, age, diabetes, malnutrition, malignancy, other chronic diseases, and immunosuppression [31,32].…”