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Rhodotorula species fungemia: a threat to the immunocompromised host

Maria Anatoliotaki1, Elpis Mantadakis, Emmanuel Galanakis

  • 1The University of Crete, Division of Medicine, Heraklion, Crete, Greece.

Clinical Laboratory
|February 21, 2003
PubMed

Insights

Rhodotorula fungi, once considered harmless, are now opportunistic pathogens in immunocompromised individuals. Most Rhodotorula fungemia cases are catheter-related in cancer patients, often resolving with catheter removal and supportive care.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Rhodotorula are ubiquitous airborne fungi, previously classified as non-pathogenic saprophytes.
  • Recent decades show an emergence of Rhodotorula as opportunistic pathogens, particularly in immunocompromised populations.
  • This shift necessitates a re-evaluation of their clinical significance and management.

Purpose of the Study:

  • To review and analyze reported cases of Rhodotorula species fungemia.
  • To understand the epidemiological trends and clinical characteristics of these infections.
  • To evaluate current treatment strategies and outcomes for Rhodotorula fungemia.

Main Methods:

  • Comprehensive literature search of English-language publications from 1960 to 2001.
  • Inclusion of reported cases of Rhodotorula species fungemia.
  • Analysis of patient demographics, infection sources, clinical features, and treatment outcomes.

Main Results:

  • A total of 47 cases of Rhodotorula spp fungemia were identified between 1960 and 2001.
  • The majority of reported infections occurred after 1990, were associated with central venous catheters, and diagnosed in cancer patients.
  • Most patients survived, with recovery often linked to resolution of neutropenia and central venous catheter removal.

Conclusions:

  • Rhodotorula fungemia is an emerging opportunistic infection, primarily affecting immunocompromised patients, especially those with cancer and central venous catheters.
  • Central venous catheter removal is a critical intervention, and systemic antifungal therapy may not always be necessary.
  • Amphotericin B is the preferred treatment if catheter removal is not feasible or infection persists, though Rhodotorula generally exhibits low virulence and fatality rates.

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