title: A case of Candida lambica fungemia misidentified as Candida krusei in an intravenous drug abuser.
abstract: Only a handful of cases of human Candida lambica infections have been published up to now. We report a Candida lambica fungemia in a young intravenous drug abuser. Using a popular chromogenic agar and a commercial phenotyping gallery, the fungus was initially misidentified as Candida krusei. Key tests to distinguish these closely related species are maximum growth temperature and assimilation of certain substrates present in more elaborate phenotyping assays. Definite confirmation is possible using molecular techniques. Susceptibility testing of the isolate demonstrated amphotericin B (MIC 0.125 microg/ml) susceptible, flucytosine (MIC 2 microg/ml) susceptible, itraconazole (MIC 0.064 microg/ml) susceptible, voriconazole (MIC 1 microg/ml) susceptible, and fluconazole (MIC >64 microg/ml, resistant).
authors.affiliation: Department of Microbiology, Heilig-Hartziekenhuis Roeselare-Menen, Roeselare, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Vervaeke
authors.forename: Kathy
authors.initials: K
authors.lastname: Vandamme
authors.forename: Elke
authors.initials: E
authors.lastname: Boone
authors.forename: Emmanuel
authors.initials: E
authors.lastname: De Laere
authors.forename: Danielle
authors.initials: D
authors.lastname: Swinne
authors.forename: Ignace
authors.initials: I
authors.lastname: Surmont
mesh_terms: D000666:Amphotericin B / Q000494:pharmacology / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D002175:Candida / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D002177:Candidiasis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D003951:Diagnostic Errors; D025141:Drug Resistance, Fungal / Q000187:drug effects; D015725:Fluconazole / Q000494:pharmacology / Q000627:therapeutic use; D016469:Fungemia / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D016533:Mycological Typing Techniques / Q000379:methods*; D016133:Polymerase Chain Reaction; D015819:Substance Abuse, Intravenous / Q000150:complications*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole