Lodderomyces elongisporus: An emerging human fungal pathogen

Wang, Yue; Xu, Jianping

doi:10.1371/journal.ppat.1011613

Cited by 8 publications

(9 citation statements)

References 34 publications

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“…In Malaysia, there are four cases before this, making this the fifth. Most cases are found in extreme age groups, specifically the elderly and infants [5]. On top of that, nearly all cases had underlying conditions, with four of them having malignancy [5], like in our patient.…”

Section: Discussionsupporting

confidence: 53%

“…Most cases are found in extreme age groups, specifically the elderly and infants [5]. On top of that, nearly all cases had underlying conditions, with four of them having malignancy [5], like in our patient. Solid tumor is one of the most common host risk factors for developing invasive fungal infections [10], with gastrointestinal tumors being the most frequent type [11].…”

Section: Discussionsupporting

confidence: 53%

“…Lodderomyces elongisporus is a rare but emerging infection that should be taken note of, from being isolated in fruits and soft drinks [2] to being described as a fatal bloodstream infection [7]. To the best of our knowledge, 40 Lodderomyces elongisporus cases are reported worldwide, including our current case [5]. The majority of the cases occur in Asian countries, with India having the highest reported numbers to date [8,9].…”

Section: Discussionmentioning

confidence: 81%

“…Out of the 39 reported cases of Lodderomyces elongisporus, eight resulted in death, giving a mortality rate of 20% [5]. Comorbidities such as heart disease, advanced malignancy, and end-stage renal failure were described in adult patients with fatal Lodderomyces elongisporus infection [5].…”

Section: Discussionmentioning

confidence: 99%

“…Older yeast identification systems such as VITEK had many times misidentified it as C. parapsilosis, resulting in the underreporting of cases [3,4]. In recent years, we have observed a rising number of Lodderomyces elongisporus cases ranging from catheter-related bloodstream infection to infective endocarditis, among others, due to the improvement of yeast identification systems [5]. On the other hand, Pantoea dispersa is a gram-negative bacteria found in the natural environment with agricultural and industrial benefits [6].…”

Section: Introductionmentioning

confidence: 99%

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Disseminated Lodderomyces elongisporus and Pantoea dispersa: A Rare Dual Infection in an Immunocompromised Patient

San,

Mohamed Sukur,

Abdul Hameed

et al. 2024

Cureus

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With the advancement of modern medicine and the prolonged survival of critically ill patients, unusual organisms are increasingly emerging. Initially found in the environment, these rare organisms started presenting as human pathogens, causing significant morbidity and mortality. Here, we present a rare case of disseminated Lodderomyces elongisporus fungemia and Pantoea dispersa bacteremia in a patient with parapneumonic effusion and ruptured liver abscess. This yeast was identified using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF). Although this organism has no antifungal breakpoint, the isolate shows low minimum inhibitory concentration (MIC) to a wide range of antifungals. The importance of effective communication between microbiologists and clinicians and early referral to the infectious disease team was also highlighted in this case for prompt treatment.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Disseminated Lodderomyces elongisporus and Pantoea dispersa: A Rare Dual Infection in an Immunocompromised Patient

San,

Mohamed Sukur,

Abdul Hameed

et al. 2024

Cureus

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Unveiling Lodderomyces elongisporus as an Emerging Yeast Pathogen: A Holistic Approach to Microbiological Diagnostic Strategies

Muangkaew,

Thanomsridetchai,

Tangwattanachuleeporn

et al. 2024

Mycopathologia

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Lodderomyces elongisporus, first isolated in 1952, has increasingly been recognized as a significant pathogen, with a notable rise in human infections since the 1970s. Initially misidentified as Candida parapsilosis due to morphological similarities, L. elongisporus has now been conclusively established as a distinct species, largely due to advancements in molecular biology, particularly DNA sequencing. This review traces the detection history of L. elongisporus, from the earliest documented cases to the most recent reports, underscoring its role as a causative agent in human infections. It also explores therapeutic strategies that have demonstrated efficacy, alongside instances of environmental contamination reported in international literature. A critical evaluation of diagnostic methodologies essential for precise identification is provided, including culture-based techniques such as colony morphology on Sabouraud Dextrose Agar (SDA) and chromogenic media, coupled with microscopic assessments using Lactophenol Cotton Blue (LPCB) and Gram staining. The ultrastructure of L. elongisporus, as observed under Scanning Electron Microscopy (SEM), is also discussed. Furthermore, non-culture-based diagnostics, such as sugar utilization tests (API 20C AUX and the innovative in-house arabinose-based “Loddy” test) and antifungal susceptibility profiling, are reviewed, with a particular focus on molecular tools like ITS-DNA sequencing and MALDI-TOF MS, which, despite their higher costs, offer unparalleled specificity. The accurate distinction and characterization of L. elongisporus are paramount, particularly in vulnerable and immunocompromised patients, where misdiagnosis can lead to severe consequences. This review advocates for intensified research efforts to develop more accessible diagnostic tools and deepen our understanding of this emerging pathogen, ultimately aiming to improve patient outcomes.

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