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.
Goldani
L Z
LZ
Department of Medicine, Boston University Medical Center, MA 02118, USA.
Craven
D E
DE
Sugar
A M
AM
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