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Rhodotorula septicemia: two cases and a review of the literature
Abstract:
Rhodotorula glutinis var. glutinis was isolated from the blood of two patients who were seriously ill and required long-term intravenous therapy. Although both isolates were sensitive to amphotericin B and 5-fluorocytosine, neither patient received antifungal therapy. One of the two patients died, but Rhodotorula was not recovered at autopsy. Review of the literature shows that Rhodotorula septicemia is often associated with contamination of intravenous infusion equipment, resulting in toxemia and hypotension. Initial therapy for fungemia should consist of removal of infected cannulas and fluid replacement. If fungemia persists, antifungal drug therapy should be considered.
Insights
Rhodotorula glutinis fungemia in critically ill patients can arise from contaminated intravenous equipment. Prompt removal of infected cannulas and fluid replacement are crucial initial steps for managing this serious bloodstream infection.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Critical Care Medicine
Background:
- Rhodotorula glutinis var. glutinis is an opportunistic yeast pathogen.
- Serious illness and long-term intravenous therapy are risk factors for fungemia.
- Rhodotorula septicemia is often linked to contaminated intravenous infusion equipment.
Observation:
- Two critically ill patients with fungemia caused by Rhodotorula glutinis var. glutinis were identified.
- Both isolates were susceptible to amphotericin B and 5-fluorocytosine.
- Neither patient received specific antifungal treatment.
Findings:
- One patient with Rhodotorula septicemia died; the yeast was not detected post-mortem.
- Literature review indicates Rhodotorula septicemia can cause toxemia and hypotension.
- Contamination of intravenous infusion equipment is a common source.
Implications:
- Initial management of fungemia should prioritize removal of infected cannulas and fluid resuscitation.
- Antifungal drug therapy should be considered if fungemia persists after initial interventions.
- This case highlights the importance of vigilance for Rhodotorula in immunocompromised patients with central venous catheters.