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Infecting Mice with Malassezia spp. to Study the Fungus-Host Interaction
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Catheter-related Malassezia furfur fungemia in immunocompromised patients

G R Barber1, A E Brown, T E Kiehn

  • 1Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.

The American Journal of Medicine
|October 1, 1993
PubMed
Abstract

Insights

Catheter-related Malassezia furfur fungemia can occur in immunocompromised patients, not just neonates. Early amphotericin B treatment may prevent central venous access device removal.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Malassezia furfur is a known cause of catheter-related sepsis in neonates, often linked to lipid emulsions.
  • Previous understanding primarily associated M. furfur fungemia with neonatal populations and intravenous lipid use.

Purpose of the Study:

  • To report cases of catheter-related Malassezia furfur fungemia in non-neonatal immunocompromised patients.
  • To investigate the association between M. furfur fungemia and central venous access devices in this patient group.
  • To evaluate treatment outcomes and the role of lipid emulsions.

Main Methods:

  • Retrospective case series of seven immunocompromised patients (four adults, three children) with M. furfur fungemia.
  • Analysis of blood cultures from central venous access devices.
  • Review of patient demographics, lipid emulsion use, and treatment regimens.

Main Results:

  • All seven patients had positive blood cultures from central venous access devices.
  • Only two patients received concurrent intravenous lipid emulsion.
  • Quantitative M. furfur colony counts varied, and amphotericin B was the primary treatment.
  • One device required removal due to persistent fungemia despite treatment.

Conclusions:

  • Catheter-related M. furfur fungemia is a risk in immunocompromised patients with central venous access devices, independent of lipid emulsion use.
  • Prompt amphotericin B treatment (1 mg/kg/d) can potentially avoid device removal.
  • Further research is needed on the role of endogenous lipids and potential seasonal incidence in non-neonatal populations.

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