title: Fungemia due to Rhodotorula mucilaginosa after allogeneic hematopoietic stem cell transplantation.
abstract: Rhodotorula species have been increasingly recognized as emerging pathogens, particularly in immunocompromised patients. We herein report on a patient with myelodysplastic syndrome who developed fungemia due to Rhodotorula mucilaginosa after allogeneic hematopoietic stem cell transplantation (HSCT) from an unrelated donor. He developed severe acute graft-versus-host disease requiring high-dose steroids, and had serially been administered fluconazole and micafungin for the prophylaxis of fungal infection. Although several cases of Rhodotorula infection after HSCT have been reported, all of them were recipients of autologous HSCT, not allogeneic HSCT. A review of all the reported cases of Rhodotorula infection after HSCT revealed that all patients had received fluconazole or echinocandins before the onset of infection. The findings suggest that Rhodotorula species could be causative yeasts, particularly in patients receiving fluconazole or echinocandins, both of which are inactive against the species.
authors.affiliation: Department of Medicine, Division of Hematology, Keio University School of Medicine, Tokyo, Japan. tmori@sc.itc.keio.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Mori
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: J
authors.initials: J
authors.lastname: Kato
authors.forename: K
authors.initials: K
authors.lastname: Sugita
authors.forename: M
authors.initials: M
authors.lastname: Murata
authors.forename: K
authors.initials: K
authors.lastname: Kamei
authors.forename: S
authors.initials: S
authors.lastname: Okamoto
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D016469:Fungemia / Q000188:drug therapy / Q000382:microbiology*; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000382:microbiology*; D009190:Myelodysplastic Syndromes / Q000628:therapy; D012248:Rhodotorula / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D014184:Transplantation, Homologous / Q000009:adverse effects; D061349:Unrelated Donors
chemical_list: D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B