Fungemia caused by Aureobasidium pullulans in a patient with advanced AIDS: a case report and review of the medical literature

Mittal, Jaimie; Szymczak, Wendy; Pirofski, Liise-anne; Galen, Benjamin T.

doi:10.1099/jmmcr.0.005144

Cited by 12 publications

(12 citation statements)

References 14 publications

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“…Little is known about the predisposing factors for Aureobasidium infections. Previous case reports and studies revealed the risk factors of Aureobasidium infection, such as immunosuppressant use, steroids and HIV infection [ 21 ], cancer (with chemotherapy) [ 22 ], transplantation [ 23 ], trauma history [ 24 ], asplenia [ 25 ], leukemia [ 25 , 26 ], and parenteral nutrition [ 21 , 22 ]. Aureobasidium might be a more important pathogen in the future because of iatrogenic immunosuppression, such as solid organ transplant and massive chemotherapy, and artificial devices, such as central venous ports, would be increasing.…”

Section: Discussionmentioning

confidence: 99%

Aureobasidium melanigenum catheter-related bloodstream infection: a case report

et al. 2022

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Background Aureobasidium melanigenum is a ubiquitous dematiaceous fungus that rarely causes invasive human infections. Here, we present a case of Aureobasidium melanigenum bloodstream infection in a 20-year-old man with long-term catheter use. Case presentation A 20-year-old man receiving home care with severe disabilities due to cerebral palsy and short bowel syndrome, resulting in long-term central venous catheter use, was referred to our hospital with a fever. After the detection of yeast-like cells in blood cultures on day 3, antifungal therapy was initiated. Two identification tests performed at a clinical microbiological laboratory showed different identification results: Aureobasidium pullulans from matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and Cryptococcus albidus from a VITEK2 system. Therefore, we changed the antifungal drug to liposomal amphotericin B. The fungus was identified as A. melanigenum by DNA sequence-based analysis. The patient recovered with antifungal therapy and long-term catheter removal. Conclusion It is difficult to correctly identify A. melanigenum by routine microbiological testing. Clinicians must pay attention to the process of identification of yeast-like cells and retain A. melanigenum in cases of refractory fungal infection.

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Section: Discussionmentioning

confidence: 99%

Aureobasidium melanigenum catheter-related bloodstream infection: a case report

et al. 2022

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“…Other antifungal regimens had been reported to be effective such as amphotericin B combination with fluconazole [12,14,15], voriconazole [13], micafungin [16] or natamycin and fluconazole [10], as well as voriconazole alone [17], fluconazole alone [11] or in combination with flucytosine [1]. Unfortunately, 3 and 1 cases were unsuccessfully treated with amphotericin B [2,8,9] and with micafungin [18] resulting patient's dead subsequently. Due to lack of a standard treatment of A. pullulans peritonitis and its rarity, liposomal amphotericin B administration for 2 weeks with early catheter removal provided a good clinical outcome as presented here.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal dialysis (PD) catheter-related peritonitis from Aureobasidium pullulans caused by poor caregiver's hand hygiene

Chamroensakchai

Leedumrongwattanakul

Takkavatakarn

et al. 2019

Medical Mycology Case Reports

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Catheter-related peritonitis is common but rarely caused by fungal infection. We report the first case of PD patients with catheter-related peritonitis form Aureobasidium pullulans , a black yeast-like dematiaceous fungus, and reviewing the relevant literatures. A potential cause of this infection is poor hand hygiene and improper fingernail care. The infection could be prevented if patient and caregiver strictly follow hand-washing protocols.

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“…Morais OOD reported a case of a patient with infection of the lymphatic system by A. pullulans [20]. The latest report on A. plullans infection is a case of co-infection of AIDS patients in 2018 [21]. It is generally believed that systemic infection is associated with immunodeficiency or the use of immunosuppressive agents [22].…”

Section: Discussionmentioning

confidence: 99%

Molecular diagnosis and source tracing of an infection of Aureobasidium pullulans

Liu¹,

Shi

et al. 2019

J Infect Dev Ctries

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Aureobasidium pullulans (A. pullulans) is a dematiaceous, yeast-like fungus that is ubiquitous in nature, which can colonize the human hair and skin. A. pullulans has been clinically implicated to cause skin and soft tissue infections, meningitis, splenic abscesses, and peritonitis. Herein, molecular diagnostic of internal transcribed spacer (ITS) sequencing was used to investigate a suspected case of A. pullulans infection, and the infection source had been traced. A 27-year-old female case was suspected of kala-azar due to the recurrent fever. Bone marrow specimens were analyzed. The samples were negative for Leishmania, Penicillium marneffei and Histoplasma capsulatum. DNA was extracted from the bone marrow specimens, and the 583-bp sequence was amplified with the fungal ITS universal primers. The sequence was compared by Blast query to be identified as A. pullulans. A strain of A. pullulans was also isolated from the kitchen of the patient’s living room. Culture characteristics were the same as the human pathogens of A. pullulans, and the ITS sequence was identical to the bone marrow ITS amplification. In conclusion, a deep infection caused by A. pullulans is rare, often occurring in the indwelling catheter, which may cause peritonitis and other symptoms. ITS sequencing of fungi can be used as a diagnostic reference. As A. pullulans is a common fungus in environment, amplification of ITS sequence of A. pullulans in the aseptic body fluid would be necessary to make a comprehensive diagnosis based on the clinical symptoms and signs.

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Fungemia caused by Aureobasidium pullulans in a patient with advanced AIDS: a case report and review of the medical literature

Cited by 12 publications

References 14 publications

Aureobasidium melanigenum catheter-related bloodstream infection: a case report

Aureobasidium melanigenum catheter-related bloodstream infection: a case report

Peritoneal dialysis (PD) catheter-related peritonitis from Aureobasidium pullulans caused by poor caregiver's hand hygiene

Molecular diagnosis and source tracing of an infection of Aureobasidium pullulans

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