Aureobasidium pullulans var. melanigenum fungemia in a pediatric patient.
This report describes a chronically ill child who presented with high fever and was diagnosed with catheter-related sepsis. Aureobasidium pullulans variety melanigenum, a dematiaceous fungus that rarely causes opportunistic infections, was recovered from multiple blood cultures. Antifungal susceptibilities were performed and the minimum inhibitory concentration (MIC) for fluconazole was 64 mg/l, suggestive of fluconazole resistance. The patient made a full recovery after removal of the catheter line and treatment with liposomal amphotericin B. This is the first case report of an elevated in vitro fluconazole MIC of an A. pullulans isolate and only the third case of successful treatment of A. pullulans fungemia.
Department of Pathology & Laboratory Medicine, University of California, Los Angeles, Los Angeles, California, USA. kmershon@mednet.ucla.edu
Kileen L
KL
Mershon-Shier
Jaime G
JG
Deville
Shirley
S
Delair
Annette W
AW
Fothergill
Brian
B
Wickes
G Sybren
GS
de Hoog
Deanna A
DA
Sutton
Michael A
MA
Lewinski
D000666:Amphotericin B / Q000494:pharmacology / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D001203:Ascomycota / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D001769:Blood / Q000382:microbiology; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D002648:Child; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D025141:Drug Resistance, Fungal; D015725:Fluconazole / Q000494:pharmacology; D016469:Fungemia / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D017422:Sequence Analysis, DNA
D000935:Antifungal Agents; D004271:DNA, Fungal; D021903:DNA, Ribosomal Spacer; C068538:liposomal amphotericin B; D000666:Amphotericin B; D015725:Fluconazole