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Emergence of a new opportunistic pathogen, Candida lusitaniae
R J Blinkhorn1, D Adelstein, P J Spagnuolo
1Department of Medicine, Case Western Reserve University, Cleveland Metropolitan General Hospital, Ohio 44109.
Abstract:
Candida lusitaniae has been an infrequently reported opportunistic pathogen. Most previously reported cases of serious infection caused by this organism have proven fatal and were associated with amphotericin resistance of the organism. We report two patients with hematologic malignancies undergoing cytotoxic chemotherapy who developed fungemia with this organism while they were granulocytopenic. The organisms isolated from each patient were fully susceptible and were treated successfully with amphotericin B. When isolated from an immunocompromised host, C. lusitaniae should be considered an opportunistic pathogen and undergo antifungal susceptibility testing. Amphotericin B should be considered the drug of choice, but a poor clinical response may be indicative of a resistant isolate.
Insights
Candida lusitaniae can cause serious infections in immunocompromised patients. Early antifungal susceptibility testing is crucial, as amphotericin B is effective against susceptible strains.
Area of Science:
- Mycology
- Infectious Diseases
- Hematology
Background:
- Candida lusitaniae is an opportunistic pathogen.
- Serious infections are often fatal and linked to amphotericin resistance.
Observation:
- Two patients with hematologic malignancies developed fungemia during chemotherapy.
- Both patients were granulocytopenic at the time of infection.
Findings:
- The isolated C. lusitaniae strains were susceptible to amphotericin B.
- Successful treatment with amphotericin B was achieved in both cases.
Implications:
- C. lusitaniae should be considered a significant opportunistic pathogen in immunocompromised hosts.
- Antifungal susceptibility testing is essential for guiding treatment decisions.
- Amphotericin B is a potential first-line treatment, but resistance should be monitored.