Abstract
We report an atypical case of Rhodotorula mucilaginosa fungemia coexisting with pleural tuberculosis, in an immunocompetent host. The patient was an inhaled drug abuser and worked in a fruit market. The diagnosis of Rhodotorula mucilaginosa infection was established by the isolation of the yeast in two blood cultures followed by a good response to amphotericin B treatment. Persistent evening fever and pleural effusion led to the second diagnosis—pleural tuberculosis. In the last 5 years, this was the only case of Rhodotorula mucilaginosa fungemia in our hospital and the first case in the literature that documents Rhodotorula mucilaginosa fungemia associated with pleural tuberculosis.
References
Kim HA, Hyun M, Ryu SY. Catheter-Associated Rhodotorula mucilaginosa Fungemia in an Immunocompetent Host. Infect Chemother. 2013;45(3):339–42.
Wirth F, Goldani LZ. Epidemiology of Rhodotorula: an emerging pathogen. Interdiscip Perspect Infect Dis. 2012;. doi:10.1155/2012/465717.
Chung JW, Kim BN, Kim YS. Central venous catheter-related Rhodotorula rubra fungemia. J Infect Chemother. 2002;8(1):109–10.
Re Lo V, Fishman NO, Nachamkin I. Recurrent catheter-related Rhodotorula rubra infection. Clin Microbiol Infect. 2003;9(8):897–900.
Lunardi LW, Aquino VR, Zimerman RA, Goldani LZ. Epidemiology and outcome of Rhodotorula fungemia in a tertiary care hospital. Clin Infect Dis. 2006;43(6):e60–3.
Tuon FF, de Almeida GM, Costa SF. Central venous catheter-associated fungemia due to Rhodotorula spp.—a systematic review. Med Mycol. 2007;45(5):441–7.
Villar JM, Velasco CG, Delgado JD. Fungemia due to Rhodotorula mucilaginosa in an immunocompetent, critically ill patient. J Infect Chemother. 2012;18(4):581–3.
Spiliopoulou A, Anastassiou ED, Christofidou M. Rhodotorula fungemia of an intensive care unit patient and review of published cases. Mycopathologia. 2012;174(4):301–9.
De Almeida GM, Costa SF, Melhem M, Motta AL, Szeszs MW, Miyashita F, et al. Rhodotorula spp. isolated from blood cultures: clinical and microbiological aspects. Med Mycol. 2008;46(6):547–56.
Louria DB, Greenberg SM, Molander DW. Fungemia caused by certain nonpathogenic strains of the family Cryptococcaceae. Report of two cases due to Rhodotorula and Torulopsis glabrata. N Engl J Med. 1960;263:1281–4.
Krcmery V, Laho L, Huttova M, Ondrusova A, Kralinsky K, Pevalova L, et al. Aetiology, antifungal susceptibility, risk factors and outcome in 201 fungaemic children: data from a 12-year prospective national study from Slovakia. J Med Microbiol. 2002;51(2):110–6.
Tuon FF, Costa SF. Rhodotorula infection. A systematic review of 128 cases from literature. Rev Iberoam Micol. 2008;25(3):135–40.
Miceli MH, Díaz JA, Lee SA. Emerging opportunistic yeast infections. Lancet Infect Dis. 2011;11(2):142–51.
Larone DH. Medically important fungi: a guide to identification. 4th ed. Washington: ASM Press; 2002.
Thanos L, Mylona S, Kokkinaki A, Pomoni M, Tsiouris S, Batakis N. Multifocal skeletal tuberculosis with Rhodotorula minuta co-infection. Scand J Infect Dis. 2006;38(4):309–11.
Galán-Sánchez F, García-Martos P, Rodríguez-Ramos C, Marín-Casanova P, Mira-Gutiérrez J. Microbiological characteristics and susceptibility patterns of strains of Rhodotorula isolated from clinical samples. Mycopathologia. 1999;145(3):109–12.
Zaas AK, Boyce M, Schell W, Lodge BA, Miller JL, Perfect JR. Risk of fungemia due to Rhodotorula and antifungal susceptibility testing of Rhodotorula isolates. J Clin Microbiol. 2003;41(11):5233–5.
Arendrup MC, Boekhout T, Akova M, Meis JF, Cornely OA, Lortholary O, et al. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of rare invasive yeast infections. Clin Microbiol Infect. 2014;20(Suppl 3):76–98.
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Pereira, C., Ribeiro, S., Lopes, V. et al. Rhodotorula mucilaginosa Fungemia and Pleural Tuberculosis in an Immunocompetent Patient: An Uncommon Association. Mycopathologia 181, 145–149 (2016). https://doi.org/10.1007/s11046-015-9942-x
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DOI: https://doi.org/10.1007/s11046-015-9942-x