Fluconazole resistance of Candida krusei

We present a case of young male treated for a recurrence of Acute Non Lymphoid Leukemia who presented a colonization by C. krusei during prophylaxis with Fluconazole. The fever episode, which he developed while neutropenic, was resolved with the addition of Amphotericin B after the failure of empiric antibiotic therapy. No isolation was performed in blood cultures. A second cycle of antiblastic chemotherapy was needed because of the resistance shown to the first. Despite the prophylaxis with Fluconazole a stream of C. krusei grew in all the blood cultures collected while febrile. Amphotericin B administered did not control the fungemia. We discuss the resistance of C. krusei to Fluconazole.