Saccharomyces cerevisiae fungemia due to an unexpected source in the pediatric intensive care unit

Area of Science:

• Medical Microbiology
• Pediatric Critical Care
• Infectious Diseases

Background:

• Saccharomyces cerevisiae is a yeast frequently used as a probiotic agent.
• While generally considered non-pathogenic, it can cause fungemia, particularly in vulnerable populations like immunocompromised individuals and hospitalized children.
• The risk of fungemia is heightened in patients with indwelling medical devices and prolonged hospital stays.

Observation:

• A case of a 6-month-old infant in the pediatric intensive care unit (PICU) developed Saccharomyces cerevisiae fungemia.
• The infant had a history of hydrocephalus, intracranial mass, and required a ventriculoperitoneal shunt and external drainage.
• The yeast was isolated from a central venous catheter (CVC) culture, leading to its removal and antifungal treatment.

Findings:

• The patient's clinical condition improved, with fever resolution and normalization of laboratory values after CVC removal and initiation of caspofungin therapy.
• A potential source of Saccharomyces exposure was noted, with a nearby patient receiving a probiotic containing Saccharomyces boulardii.

Implications:

• The findings suggest that probiotics containing Saccharomyces species may pose a risk of fungemia in the PICU setting.
• Caution is advised regarding the use of probiotics in critically ill children, especially those with central venous catheters.
• This case highlights the importance of considering probiotic use as a potential source of infection in pediatric intensive care.