Uncommon cause of fungemia in a patient with renal cell cancer

Mishra, Rashmi; Kelly, Paul; Toolsie, Omesh; Ayyadurai, Puvanalingam; Adrish, Muhammad

doi:10.1097/md.0000000000008510

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…C. lusitaniae is a rare opportunistic infection that causes disseminated infections in immunocompromised patients with underlying malignancy and/or undergoing chemotherapy [2,4,5]. Our patient does not have the typical risk factors for C. lusitaniae.…”

Section: Discussionmentioning

confidence: 70%

Disseminated Candida lusitaniae: Nosocomial Acquisition Secondary to an Indwelling Urinary Catheter

Raja¹,

Park

2021

Case Reports in Infectious Diseases

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Candida lusitaniae is a rare opportunistic pathogen, and its most common risk factors include immunocompromised patients often with an underlying malignancy. It commonly displays resistance to amphotericin B, and historically, echinocandins have been considered first-line treatment. We present a 77-year-old male with a history of diabetes mellitus. He was treated for cellulitis and discharged to a skilled nursing facility with an indwelling urinary catheter. Despite recommendations from the medicine team to remove the catheter, the patient refused even after discussing the risks and benefits. He returned to the hospital 3 weeks later with symptoms of dysarthria, right-sided facial droop, and right-sided weakness. Ultimately, he was determined to have fungemia and native valve endocarditis due to Candida lusitaniae stemming from his indwelling urinary catheter. He was treated with micafungin, but repeated blood cultures continued to grow C. lusitaniae, and he eventually expired following withdrawal of care. We present this case report to illustrate a rare occurence of Candida lusitaniae in a patient without typical risk factors. C. lusitaniae fungemia is an extremely uncommon disease in patients without underlying malignancy. Despite this lack of apparent, classic risk factors, our patient developed endocarditis of his native valve due to C. lusitaniae fungemia from an indwelling urinary catheter. The ability of this organism to form biofilms, and its rapid mutation rate, makes treating C. lusitaniae very difficult. The treatment of choice for C. lusitaniae endocarditis is surgical intervention due to biofilm formation on the cardiac valves. Medical treatment recommendations are currently fluconazole, which is in contrast to the historical use of echinocandins. Infection due to Candida lusitaniae, though rare, should be remembered by clinicians. This particular fungal agent is especially difficult to treat due to its multiple virulence factors. Additionally, the use of indwelling urinary catheters should only occur when proper indications are present and should be promptly discontinued when their placement is no longer necessary.

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Section: Discussionmentioning

confidence: 70%

Disseminated Candida lusitaniae: Nosocomial Acquisition Secondary to an Indwelling Urinary Catheter

Raja¹,

Park

2021

Case Reports in Infectious Diseases

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“…C. lusitaniae is an extremely uncommon opportunistic infection that causes invasive infections in immunocompromised patients with underlying malignancy and/or those undergoing chemotherapy [ 6 , 12 , 13 ]. While our patient did not present with the classical risk factors for C. lusitaniae , we surmise that the use of broad-spectrum antibiotics early in the patient’s hospital course may have increased his susceptibility to the fungal infection with C. lusitaniae ; it has been documented as contributive to colonization and infection in patients with prolonged hospitalizations and use of broad-spectrum antibiotics [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Candida lusitaniae, an Emerging Opportunistic Pathogen in Immunocompetent Populations: A Case Report

Haseeb ul Rasool,

Swaminathan,

Hosna

et al. 2023

Cureus

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Candida lusitaniae is an emerging opportunistic pathogen in immunocompromised hosts and hospitalized patients. However, the incidence is low in immunocompetent hosts. Because of their characteristic similarities, C. lusitaniae may be confused with other fungal species, such as Candida tropicalis, Candida parapsilosis, and even Saccharomyces cerevisiae. Recently reported cases of serious infections caused by C. lusitaniae have proven detrimental, and some cases reported amphotericin resistance. Here, we present a case report of empyema caused by C. lusitaniae in an immunocompetent patient who was admitted to the intensive care unit and intubated for acute hypoxic respiratory failure. This case demonstrates the importance of recognizing this organism and initiating early treatment for the prevention of fatal complications.

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“…In the article, “Uncommon cause of fungemia in a patient with renal cell cancer: A case report of Candida lusitaniae Fungemia”, [ 1 ] which appeared in Volume 96, Issue 45 of Medicine , Dr. Puvanalingam Ayyadurai's first name appeared incorrectly as Puvvalingam.…”

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confidence: 99%