Abstract
Malassezia furfur fungaemia is reported in six preterm infants receiving a parenteral fat emulsion through a deep central venous catheter. The fungus was detected in blood cultures drawn through the catheter. The features of these cases are compared to those reported since 1981, whenM. furfur was described for the first time as a cause of deep tissue infection. Clinical signs such as fever, in spite of broadspectrum antibiotics, and the presence of pulmonary infiltrates, associated with leucocytosis and thrombocytopenia in neonatcs with cardiac or pulmonary disease should raise the suspicion ofM. furfur fungaemia. The laboratory should be informed of this possibility since routine blood culture techniques are not appropriate for the isolation of this lipid-dependent organism. Treatment of the condition consists in removal of the catheter and discontinuation of the lipid administration. Effects and choice of antifungal therapy should be further investigated.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- BPD:
-
bronchopulmonary dysplasia
- CVC:
-
central venous catheter
References
Baley JE, Kliegman M, Fanaroff AA (1984) Disseminated fungal infections in very low-birth-weight infants: therapeutic toxicity. Pediatrics 73:153–157
Dankner WM, Spector SA, Fiere J, Davis CE (1987) Mallassezia fungemia in neonates and adults: complication of hyperalimentation. Rev Infect Dis 9:743–753
Faergeman J, Fredriksson T (1980) Age incidence ofPityrosporum orbiculare on human skin. Acta Dermatol Venereol (Stockh) 60:531–533
Faergemann J, Tjernlund U, Scheynius A, Bernander S (1982) Antigenic similarities and differences in genusPityrosporum. J Invest Dermatol 78:28–31
Hassall E, Ulich T, Ament ME (1983) Pulmonary embolus and Malassezia pulmonary infection related to urokinase therapy. J Pediatr 102:722–725
Johnson DE, Thompson TR, Green TP, Ferrieri P (1984) Systemic candidiasis in very low-birth-weight infants (<1,500 grams). Pediatrics 73:138–143
Long JG, Keyserling HL (1985) Catheter-related infection in infants due to an unusual lipophilic yeast-Malassezia furfur. Pediatrics 76:896–900
Marcon MJ, Powel DA, Durrell DE (1986) Methods for optimal recovery ofMalassezia furfur brom blood culture. J Clin Microbiol 24:696–700
Meunier-Carpentier F, Kiehn TE, Armstrong D (1981) Fungemie in the immunocompromised host: changing patterns, antigenemia, high mortality. Am J Med 71:363–370
Nazzaro Porro M, Passi S, Caprilli F, Nazzaro P, Morpurgo G (1976) Growth requirements and lipid metabolism ofPityrosporum orbiculare, J Invest Dermatol 66:178–182
Oberle AD, Fowler M, Grafton WD (1981)Pityrosporum isolate from the upper respiratory tract. Am J Clin Pathol 76:112–116
Plouffe JF, Brown DG, Silva J, Eck T, Stricof RL, Fekety FR (1977) Nosocomial outbreak ofCandida parapsilosis fungemia related to intravenous infusions. Arch Intern Med 137:1686–1689
Powell DA, Aungst J, Snedden S, Hansen N, Brady M (1984) Broviac catheterrelatedMalassezia furfur sepsis in five infants receiving intravenous fat emulsions. J Pediatr 105:987–990
Powell DA, Durrell DE, Marcon MJ (1986) Growth ofMalassezia furfur in parenteral fat emulsions. J Infect Dis 153:640–641
Redline RW, Dahms BB (1981) Malassezia pulmonary vasculitis in an infant in long-term Intralipid therapy. N Engl J Med 305:1395–1398
Redline RW, Redline SS, Boxerbaum B, Dahms BB (1985) SystemicMalassezia furfur infections in patients receiving Intralipid therapy. Hum Pathol 16:815–822
Salkin IF, Gordon MA (1977) Polymorphism ofMalassezia furfur. Can J Microbiol 23:471–475
Solomon SL, Khabbaz RF, Parker RH, Anderson RL, Geraghty MA, Furman RM, Martone WJ (1984) An outbreak ofCandida parapsilosis bloodstream infections in patients receiving parenteral nutrition. J Infect Dis 149:98–102
Wallace M, Bagnall H, Glen D, Averill S (1979) Isolation of lipophilic yeast in “sterile” peritonitis. Lancet II:956
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Surmont, I., Gavilanes, A., Vandepitte, J. et al. Malassezia furfur fungaemia in infants receiving intravenous lipid emulsions. A rarity or just underestimated?. Eur J Pediatr 148, 435–438 (1989). https://doi.org/10.1007/BF00595906
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00595906