title: The first reported case of central venous catheter-related fungemia caused by Cryptococcus liquefaciens.
abstract: We describe a case of central venous catheter-related fungemia caused by Cryptococcus liquefaciens, a non-neoformans and non-gattii Cryptococcus, in a non-HIV patient. A 71-year-old man with diffuse large B-cell lymphoma receiving antineoplastic chemotherapy was febrile approximately 30 weeks after central venous port insertion, and C. liquefaciens was isolated from all three performed blood cultures as well as a central venous catheter tip culture. In vitro antifungal susceptibility tests showed that this yeast isolate was susceptible to low concentrations of amphotericin B, fluconazole, itraconazole and voriconazole yet was resistant to 5-fluorocytosine (MIC: >64 μg/ml), unlike Cryptococcus neoformans. Treatment of the patient with oral and intravenous voriconazole was effective and consistent with the susceptibility tests. Although non-neoformans and non-gattii Cryptococcus spp. are considered non-pathogenic environmental yeast, they may rarely be the causative agents of serious infections in humans, as in the present case.
authors.affiliation: Department of Microbiology, St. Marianna University School of Medicine, Japan; Department of Infection Control, St. Marianna University Hospital, Japan. Electronic address: takeh@marianna-u.ac.jp.
authors.forename: Hiromu
authors.initials: H
authors.lastname: Takemura
authors.affiliation: Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Japan; Department of Infectious Diseases and Infection Control, Saitama Medical Center, Saitama Medical University, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ohno
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Miura
authors.affiliation: Department of Infection Control, St. Marianna University Hospital, Japan.
authors.forename: Taeko
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Department of Infection Control, St. Marianna University Hospital, Japan; Department of Clinical Laboratory, St. Marianna University Hospital, Japan.
authors.forename: Tadatomo
authors.initials: T
authors.lastname: Ohyanagi
authors.affiliation: Department of Infection Control, St. Marianna University Hospital, Japan; Division of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kunishima
authors.affiliation: Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Okawara
authors.affiliation: Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Japan.
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Department of Microbiology, St. Marianna University School of Medicine, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakashima
mesh_terms: D000368:Aged; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000382:microbiology*; D062905:Central Venous Catheters / Q000009:adverse effects* / Q000382:microbiology; D003453:Cryptococcosis / Q000188:drug therapy / Q000382:microbiology*; D016469:Fungemia / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male
keywords: (1-3) ß-D-glucan; Central venous catheter; Cryptococcus liquefaciens; Fungemia; Voriconazole