<i>Rhodotorula glutinis</i> meningitis: a case report and review of literature

Menon, Sarala; Gupta, Hemlata; Sequeira, Rohan; Chavan, Shaila; Gholape, D.; Amandeep, S.; Bhilave, N.; Chowdhary, Abhay

doi:10.1111/myc.12180

Cited by 11 publications

(8 citation statements)

References 24 publications

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“…No additional studies were found by hand‐screening of the included articles’ references. Finally, 111 met the criteria . Additional information was kindly provided by the corresponding author of one study .…”

Section: Resultsmentioning

confidence: 99%

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Rhodotorula species infections in humans: A systematic review

Ιωάννου

Vamvoukaki

Samonis

2018

Mycoses

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| INTRODUC TI ONRhodotorula belongs to the phylum Basidiomycota and forms spherical-to-ellipsoidal budding yeast as well as rudimentary hyphae and small capsules. 1 It is widely distributed in the environment and is also found in the normal flora of the human gastrointestinal, respiratory and genital system as well as in the moist areas of the skin. 2 Even though it had been considered nonpathogenic, in the last decades there is growing evidence that it can be important human pathogen, especially in immunocompromised hosts, causing a variety of different infections, such as fungaemia, meningitis, peritoneal dialysis-associated peritonitis and keratitis. 3,4 The purpose of this study was to systemically review all published cases of Rhodotorula infections in the literature and describe the epidemiology, microbiology, treatment and outcomes of these infections in humans. SummaryBackground: Fungal infections by Rhodotorula species are increasingly reported in the literature and consist of bloodstream infections, especially in patients with central venous catheters (CVC), as well as central nervous system (CNS), ocular and other less frequent infections. Objectives: The aim of this systematic review was to record and evaluate all available evidence regarding infections by Rhodotorula species. Methods: Systematic review of PubMed (through 9 August 2017) for studies providing epidemiological, clinical, microbiological, as well as treatment data and outcomes of Rhodotorula species infections.Results: A total of 111 studies, containing data of 248 patients, were eventually included in the analysis. The most common Rhodotorula infections were those of bloodstream, CNS and ocular infections, as well as peritoneal dialysis-associated peritonitis.Epidemiology of each type of infection was different, with the bloodstream ones being more common in patients with malignancy and CVCs, while those of the CNS were more common in patients with AIDS. Mortality was variable being higher in CNS infections. Amphotericin B remains the most common agent used for treatment, irrespectively of the infection site. Conclusions: This systematic review thoroughly describes fungal infections byRhodotorula species and provides information on their epidemiology, clinical picture, microbiology, treatment and outcomes. K E Y W O R D S fungaemia, fungal infection, keratitis, meningitis, peritonitis, Rhodotorula | 91 IOANNOU et Al. with the following text-word: Rhodot*[tw]. Day of last search was 9 August 2017. | Study selectionStudies were included in analysis if they met the following criteria: (a) published in English; and (b) reporting data on patients' clinical characteristics, microbiology, treatment and outcomes. From the analysis were excluded studies with the following criteria: (a) secondary research papers (eg, reviews), editorials and papers not reporting results on primary research; (b) studies not in humans; (c) studies on colonisation but not infection by Rhodotorula; and (d) studies not in English. Two investigators (PI and RV) using Ab...

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Section: Resultsmentioning

confidence: 99%

“…Among the 111 Rhodotorula infections studies, 18 (16.2%) reported CNS infections, accounting for 53 patients out of 248 (21.4%) in total . Of them, 68% were male (17 out of 25 cases w.a.d.)…”

Section: Resultsmentioning

confidence: 99%

Rhodotorula species infections in humans: A systematic review

Ιωάννου

Vamvoukaki

Samonis

2018

Mycoses

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“…R. glutinis and S. cf. roseus are both reported, albeit rarely, as opportunistic pathogens (McNicholas et al, ; Menon et al ., ). Moreover, all the fungi isolated in this study share similar metabolic and antimicrobial traits that might suggest possible symbiotic associations with mosquitoes.…”

Section: Discussionmentioning

confidence: 99%

Mosquitoes can harbour yeasts of clinical significance and contribute to their environmental dissemination

Bozic

Capone

Pediconi

et al. 2017

Environ Microbiol Rep

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There is still a lack of studies on fungal microbiota in mosquitoes, compared with the number available on bacterial microbiota. This study reports the identification of yeasts of clinical significance in laboratory mosquito species: Anopheles gambiae, Anopheles stephensi, Culex quinquefasciatus, Aedes albopictus and Aedes aegypti. Among the yeasts isolated, they focused on the opportunistic pathogen Candida parapsilosis, since there is a need to better understand breakthrough candidaemia with resistance to the usual antifungals, which requires careful consideration in the broad-spectrum therapy, as documented in many clinical reports. C. parapsilosis occurs widely and has been isolated from diverse sources, including insects, which may contribute to its dissemination. In this study, it was isolated from the gut of An. gambiae and its presence in developmental stages and organs of different mosquito species was studied. Our results indicated that there was a stable association between C. parapsilosis and reared mosquitoes during the entire life cycle, and in adult male and female gut and gonads. A wide occurrence of C. parapsilosis was also documented in several populations of wild mosquitoes. Based on these findings, it can be said that mosquitoes might participate in the spreading of this opportunistic pathogen, not only as a carrier.

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“…Steroid administration and the use of broad-spectrum antibiotics are also risk factors [ 15 ]. The cases of Rhodotorula infection reported in literature included fungemia, meningitis, endocarditis, skin lesions, eye infections, onychomycosis, and peritonitis [ 11 , 12 , 17 , 23 ]. Rhodotorula mucilaginosa was the most common species of Rhodotorula fungemia, followed by Rhodotorula glutinis [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Onychomycosis Caused byRhodotorula glutinis

Altun

Meral

Arıbaş

et al. 2014

Case Reports in Dermatological Medicine

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Rhodotorula spp. have emerged as opportunistic pathogens, particularly in immunocompromised patients. The current study reports a case of onychomycosis caused by Rhodotorula glutinis in a 74-year-old immunocompetent female. The causative agent was identified as R. glutinis based on the pinkish-orange color; mucoid-appearing yeast colonies on Sabouraud Dextrose Agar at 25°C; morphological evaluation in the Corn Meal-Tween 80 agar; observed oval/round budding yeast at 25°C for 72 hours; no observed pseudohyphae; positive urease activity at 25°C for 4 days; and assimilation features detected by API ID 32C kit and automated Vitek Yeast Biochemical Card 2 system. Antifungal susceptibility test results were as follows: amphotericin B (MIC = 0.5 µg/mL), fluconazole (MIC = 128 µg/mL), itraconazole (MIC = 0.125 µg/mL), voriconazole (MIC = 1 µg/mL), posaconazole (MIC = 0.5 µg/mL), anidulafungin (MIC = 0.5 µg/mL), and caspofungin (MIC = 16 µg/mL). Antifungal therapy was initiated with oral itraconazole at a dose of 400 mg/day; seven-day pulse therapy was planned at intervals of three weeks. Clinical recovery was observed in the clinical evaluation of the patient before the start of the third cure. Although R. glutinis has rarely been reported as the causative agent of onychomycosis, it should be considered.

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Rhodotorula glutinis meningitis: a case report and review of literature

Cited by 11 publications

References 24 publications

Rhodotorula species infections in humans: A systematic review

Rhodotorula species infections in humans: A systematic review

Mosquitoes can harbour yeasts of clinical significance and contribute to their environmental dissemination

A Case of Onychomycosis Caused byRhodotorula glutinis

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