Isolation of Naganishia diffluens (formerly Cryptococcus diffluens) from skin lesions of a patient with leukemia

Fungal diseases caused by species of the genus Cryptococcus are a growing public health problem, with the species belonging to the Cryptococcus neoformans and Cryptococcus gattii complexes being the most common and studied. In recent years, other species belonging to related genera have emerged, including Naganishia diffluens. As there are few reports on this species, it is important to emphasize its significance, particularly given that it has been found in skin lesions in immunocompromised patients, as in the case presented here. This highlights the importance of paying due attention to this species and recognizing its clinical relevance.

A 27-year-old male patient with a diagnosis of acute promyelocytic leukemia M3 (APL M3) experienced a febrile episode with skin lesions compatible with fungal infection, coinciding with marked neutropenia and the start of chemotherapy. Mycological analysis of skin lesions allowed the isolation of a fungus that was identified as N. diffluens.

The increase in the frequency of N. diffluens infections can be attributed to the rising number of patients with risk factors. The use of new microbial identification tools, such as molecular biology, which made it possible to accurately identify the causative agent, is highlighted.