Central venous catheter infection with Rhodotorula minuta in a patient with AIDS taking suppressive doses of fluconazole.
A case of Rhodotorula minuta central venous catheter infection with fungaemia is described in a patient with advanced acquired immunodeficiency syndrome (AIDS), HIV nephropathy, end-stage renal disease requiring haemodialysis, and a permanent Quinton catheter in place for 6 months. At the time of fungaemia, the patient was taking 100 mg fluconazole per os daily for a previous episode of Candida oesophagitis. R. minuta central venous catheter infection with fungaemia was successfully treated with 455 mg total dose amphotericin B (0.6 mg kg-1 day-1) over 25 days without removal of the catheter. In vitro antifungal susceptibility testing for R. minuta revealed a minimum inhibitory concentration to fluconazole of > 100 micrograms ml-1 and to amphotericin B of 1.2 microgram ml-1. Clinically evident fungaemia, even with an unusual organism such as R. minuta, may occur in patients with intravenous catheters, and while the immunosuppressed patient is receiving azole therapy.
Department of Medicine, Boston University Medical Center, MA 02118, USA.
L Z
LZ
Goldani
D E
DE
Craven
A M
AM
Sugar
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D002177:Candidiasis / Q000517:prevention & control; D002405:Catheterization, Central Venous; D004935:Esophageal Diseases / Q000382:microbiology / Q000517:prevention & control; D015725:Fluconazole / Q000627:therapeutic use*; D016469:Fungemia / Q000188:drug therapy / Q000209:etiology*; D006679:HIV Seropositivity; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D008297:Male; D006435:Renal Dialysis; D012248:Rhodotorula / Q000302:isolation & purification
D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole