Primary deep cutaneous candidiasis caused by Candida duobushaemulonii in a 68-year-old man: the first case report and literature review.
Superficial candida infections of the skin are common, but deep cutaneous candidiasis, including secondary dissemination to the skin from systemic candidiasis, candidaemia or primary invasion due to skin defects such as trauma, is rare. These patients are usually immunosuppressed, but immunocompetent hosts can be affected as well. Candida albicans is the most common pathogen. However, non-albicans Candida species can cause deep skin invasion in rare circumstances. We report a case of deep cutaneous candidiasis caused by Candida duobushaemulonii in a 68-year-old man. Deep tissue invasion was confirmed by skin histopathology examination. The pathogen was initially identified as C. haemulonii using the VITEK®2 system for microbial identification, but was later determined to be C. duobushaemulonii based on sequencing of the internal transcribed spacer region of ribosomal DNA and D1/D2 region of 26S rDNA. The patient was successfully treated with amphotericin B, followed by fluconazole and surgical intervention. To the best of our knowledge, this is the first case of deep cutaneous infection by C. duobushaemulonii.
Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Szu-Yun
http://orcid.org/0000-0001-7297-8727
SY
Fang
Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Kai-Che
KC
Wei
Department of Dermatology and Allergy, Technische Universität München, Munich, Germany.|IZZ-Immunologie Zentrum Zürich, Zürich, Switzerland.
Wen-Chieh
WC
Chen
Section of Infectious Diseases, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Shin-Jung
SJ
Lee
Department of Plastic Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Kuo-Chung
KC
Yang
Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Chieh-Shan
CS
Wu
Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Pei-Lun
PL
Sun
D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002175:Candida / Q000145:classification / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology; D002179:Candidiasis, Cutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D004271:DNA, Fungal / Q000235:genetics; D006801:Humans; D008297:Male
D000935:Antifungal Agents; D004271:DNA, Fungal; D000666:Amphotericin B

Candida duobushaemulonii
; Candida haemulonii complex; candidiasis; cutaneous; deep