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Sakai Y, Taniguchi T, Herai Y, Yahaba M, Watanabe A, Kamei K, Igari H. Fungemia With Wickerhamomyces anomalus: A Case Report and Literature Review. Cureus 2024; 16:e53550. [PMID: 38445156 PMCID: PMC10912825 DOI: 10.7759/cureus.53550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 03/07/2024] Open
Abstract
We report the case of an 84-year-old man with a history of IgG4-related sclerosing cholangitis who was diagnosed with advanced esophageal cancer and underwent radiation and chemotherapy. An implantable central venous access port was placed for chemotherapy and total parenteral nutrition. The patient presented with a fever and received antimicrobial therapy for acute cholangitis but remained febrile, and subsequently, yeast was detected in the aerobic bottle of blood culture obtained from the central venous line. The yeast was identified as Wickerhamomyces anomalus. Liposomal amphotericin B was administered, and the central line access port was removed. After confirmation of negative blood cultures and 14 days post treatment, he underwent reinsertion of the central line access port. Due to persistent pain at the insertion site, fluconazole was added for an additional 14 days, and the patient was discharged and transferred to another hospital. Wickerhamomyces anomalus is a rare fungal infection with other synonyms including Pichia anomala, Hansenula anomala, and Candida pelliculosa. A literature review of 53 case reports of Wickerhamomyces anomalus, Pichia anomala, Hansenula anomala, and Candida pelliculosa was conducted, with a total of 211 cases reviewed. Fungemia was reported in 94% of cases, with central venous catheterization, parental feeding, low birth weight, and immunocompromised status identified as major risk factors. The majority of cases were pediatric, particularly neonatal, and there were reports of nosocomial infections causing outbreaks, with some cases involving the eye such as endophthalmitis or keratitis.
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Affiliation(s)
- Yui Sakai
- Infectious Diseases, Chiba University School of Medicine, Chiba, JPN
| | | | - Yoriko Herai
- Infectious Diseases, Chiba University Hospital, Chiba, JPN
- Respiratory Medicine, Misato Central General Hospital, Misato, JPN
| | - Misuzu Yahaba
- Infectious Diseases, Chiba University Hospital, Chiba, JPN
| | - Akira Watanabe
- Clinical Research, Chiba University Medical Mycology Research Centre, Chiba, JPN
| | - Katsuhiko Kamei
- Clinical Research, Chiba University Medical Mycology Research Centre, Chiba, JPN
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Galván Ledesma A, Rodríguez Maqueda M, Talego Sancha A. Wickerhamomyces Anomalus Postoperative Endophthalmitis. Ocul Immunol Inflamm 2023; 31:1519-1521. [PMID: 36166704 DOI: 10.1080/09273948.2022.2123834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/31/2022] [Accepted: 08/10/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION We describe the case of a postoperative fungal endophthalmitis caused by Wickerhamomyces anomalus, an opportunistic yeast common in nature but rare as a causative agent in ocular infections. This would be the second reported case of W. anomalus endophthalmitis. CASE REPORT A patient came to our hospital with a dense hemovitreous caused by an inadvertent ocular perforation and retinal detachment during a cataract surgery. In the days following the first vitreoretinal surgery a chronic postoperative endophthalmitis was evidenced. Only after several surgeries as well as intravitreal antibiotics and sample takings, Wickerhamomyces was detected. The treatment with oral voriconazole and an intraocular lens extraction controlled the infection. DISCUSSION Wickerhamomyces anomalus, despite not being particularly aggressive in our case, was resistant to various consequent vitreoretinal surgeries. The unresponsiveness to treatment led us to contemplate the fungal etiology, and fortunately the cultures were positive for this yeast. In conjunction to antifungal therapy, it is possible that the IOL explantation played an important role in the treatment. CONCLUSION A high index of suspicion must be held in cases of fungal endophthalmitis. Both IOL explantation and oral antifungal therapy are useful treatment options in cases of W. anomalus endophthalmitis.
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Affiliation(s)
| | | | - Arturo Talego Sancha
- Department of Ophthalmology, Virgen Del Rocío University Hospital, Seville, Spain
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Aboutalebian S, Mirhendi H, Eshaghi H, Nikmanesh B, Charsizadeh A. The first case of Wickerhamomyces anomalus fungemia in Iran in an immuneodeficient child, a review on the literature. J Mycol Med 2023; 33:101351. [PMID: 36413850 DOI: 10.1016/j.mycmed.2022.101351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/24/2022] [Accepted: 11/09/2022] [Indexed: 11/14/2022]
Abstract
The incidence of invasive candidiasis in pediatric patients is increasing and is associated with significant morbidity and mortality. C. pelliculosa has been rarely reported as a human pathogen, however, it has been associated with serious nosocomial infections and clonal outbreaks with poor clinical outcomes in immunocompromised children were reported. Here, we describe the first case of candidemia due to Candida pelliculosa in a 5-year-old immunocompromised male suffered from Griscelli syndrome with hemophagocytic syndrome hospitalized in the pediatric intensive care unit (PICU), Tehran, Iran. In addition, the history of reported cases or case-series due to C. pelliculosa is reviewed.
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Affiliation(s)
- Shima Aboutalebian
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Mirhendi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Eshaghi
- Department of Infectious Disease, Tehran University of Medical Sciences, Tehran Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Science, School of Allied Medical Science, Tehran University of Medical Science, Tehrn, Iran; Zoonoses Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Charsizadeh
- Immunology, Asthma, and Allergy Research Institute, Tehran University of Medical Sciences, Tehran Iran.
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Overview on the Infections Related to Rare Candida species. Pathogens 2022; 11:pathogens11090963. [PMID: 36145394 PMCID: PMC9505029 DOI: 10.3390/pathogens11090963] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 11/30/2022] Open
Abstract
Atypical Candida spp. infections are rising, mostly due to the increasing numbers of immunocompromised patients. The most common Candida spp. is still Candida albicans; however, in the last decades, there has been an increase in non-Candida albicans Candida species infections (e.g., Candida glabrata, Candida parapsilosis, and Candida tropicalis). Furthermore, in the last 10 years, the reports on uncommon yeasts, such as Candida lusitaniae, Candida intermedia, or Candida norvegensis, have also worryingly increased. This review summarizes the information, mostly related to the last decade, regarding the infections, diagnosis, treatment, and resistance of these uncommon Candida species. In general, there has been an increase in the number of articles associated with the incidence of these species. Additionally, in several cases, there was a suggestive antifungal resistance, particularly with azoles, which is troublesome for therapeutic success.
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Zhang Z, Cao Y, Li Y, Chen X, Ding C, Liu Y. Risk factors and biofilm formation analyses of hospital-acquired infection of Candida pelliculosa in a neonatal intensive care unit. BMC Infect Dis 2021; 21:620. [PMID: 34187390 PMCID: PMC8244135 DOI: 10.1186/s12879-021-06295-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 06/01/2021] [Indexed: 11/28/2022] Open
Abstract
Background Candida pelliculosa is an ecological fungal species that can cause infections in immunocompromised individuals. Numerous studies globally have shown that C. pelliculosa infects neonates. An outbreak recently occurred in our neonatal intensive care unit; therefore, we aimed to evaluate the risk factors in this hospital-acquired fungal infection. Methods We performed a case-control study, analysing the potential risk factors for neonatal infections of C. pelliculosa so that infection prevention and control could be implemented in our units. Isolated strains were tested for drug resistance and biofilm formation, important factors for fungal transmission that give rise to hospital-acquired infections. Results The use of three or more broad-spectrum antimicrobials or long hospital stays were associated with higher likelihoods of infection with C. pelliculosa. The fungus was not identified on the hands of healthcare workers or in the environment. All fungal isolates were susceptible to anti-fungal medications, and after anti-fungal treatment, all infected patients recovered. Strict infection prevention and control procedures efficiently suppressed infection transmission. Intact adhesin-encoding genes, shown by genome analysis, indicated possible routes for fungal transmission. Conclusions The use of three or more broad-spectrum antimicrobials or a lengthy hospital stay is theoretically associated with the risk of infection with C. pelliculosa. Strains that we isolated are susceptible to anti-fungal medications, and these were eliminated by treating all patients with an antifungal. Transmission is likely via adhesion to the cell surface and biofilm formation. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06295-1.
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Affiliation(s)
- Zhijie Zhang
- Department of Laboratory Medicine of Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, China
| | - Yu Cao
- Department of Laboratory Medicine of Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, China
| | - Yanjian Li
- College of Life and Health Sciences, Northeastern University, 195, Chuangxin Road, Hunnan District, Shenyang, China
| | - Xufang Chen
- Department of Laboratory Medicine of Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, China
| | - Chen Ding
- College of Life and Health Sciences, Northeastern University, 195, Chuangxin Road, Hunnan District, Shenyang, China
| | - Yong Liu
- Department of Laboratory Medicine of Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, China.
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Abstract
Candida pelliculosa is a rare fungal cause of neonatal sepsis. Premature
and very low birthweight infants are at especially high risk of neonatal fungal
infections. There have been no reports of C. pelliculosa infection in
Anhui Province, China. Here, we report a case of C. pelliculosa fungemia
in a newborn boy admitted 30 minutes after delivery with grunting, cyanosis, and asphyxia.
C. pelliculosa was identified as the causative organism using blood
culture, DNA sequencing, and mass spectrometric analysis. After 20 days of fluconazole
therapy, the patient’s symptoms stabilized. Together with other relevant literature, this
report provides evidence that premature neonates are at increased risk of fungal
infections and that C. pelliculosa fungemia should be diagnosed early
using blood cultures to enable effective treatment. Fluconazole may be effective for
treating neonates with C. pelliculosa infection.
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Affiliation(s)
- Zeyu Cai
- Department of Pathology, Anhui Medical University, Hefei, Anhui, P.R China
| | - Wei Wei
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R China
| | - Zhongle Cheng
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R China
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Song KY, Park C, Byun JH, Chun HS, Choi JH, Han EH, Lee SO, Jeong Y, Kim YJ, Kim SH. Fungal arthritis with adjacent osteomyelitis caused by Candida pelliculosa: a case report. BMC Infect Dis 2020; 20:438. [PMID: 32571233 PMCID: PMC7310117 DOI: 10.1186/s12879-020-05171-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/17/2020] [Indexed: 12/15/2022] Open
Abstract
Background Candida sp. osteoarticular infection is rare and most often due to hematogenous seeding during an episode of candidemia in immunocompromised patients. However, the diagnosis can be delayed in patients with subtle symptoms and signs of joint infection without a concurrent episode of candidemia. Case presentation A 75-year-old woman presented with a three-year history of pain and swelling of the left knee. Candida pelliculosa was detected from the intraoperative tissue when the patient had undergone left total knee arthroplasty 32 months ago, but no antifungal treatment was performed. One year after the total knee arthroplasty, C. pelliculosa was repeatedly isolated from the left knee synovial fluid and antifungal treatment comprising amphotericin B deoxycholate and fluconazole was administered. However, joint infection had extended to the adjacent bone and led to progressive joint destruction. The patient underwent surgery for prosthesis removal and received prolonged antifungal treatment with micafungin and fluconazole. Conclusions This case shows that C. pelliculosa, an extremely rare non-Candida albicans sp., can cause fungal arthritis and lead to irreversible joint destruction owing to delayed diagnosis and treatment.
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Affiliation(s)
- Kwang Yun Song
- Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chulmin Park
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji-Hyun Byun
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hye-Sun Chun
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung-Hyun Choi
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Hee Han
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Ok Lee
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeonjeong Jeong
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Division of Infectious Diseases, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56 Dongsu-ro, Bupyeong-gu, Incheon, 403-720, Republic of Korea
| | - Youn Jeong Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Division of Infectious Diseases, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56 Dongsu-ro, Bupyeong-gu, Incheon, 403-720, Republic of Korea
| | - Si-Hyun Kim
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. .,Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. .,Division of Infectious Diseases, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56 Dongsu-ro, Bupyeong-gu, Incheon, 403-720, Republic of Korea.
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Voon SM, Upton A, Gupta D. Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management. Am J Ophthalmol Case Rep 2019; 15:100475. [PMID: 31198884 PMCID: PMC6557724 DOI: 10.1016/j.ajoc.2019.100475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 01/24/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022] Open
Abstract
Purpose To present a case of fungal endophthalmitis with a novel organism and our management. Observations A 46 year old male presented with delayed-onset acute endophthalmitis 6 weeks after routine phacoemulsification and intraocular lens implantation. Initial treatment with intravitreal antibiotics did not improve his condition. With repeated vitreal taps, the causative organism was eventually identified as a fungus, Pseudozyma aphidis. Treatment with oral and intravitreal voriconazole, as well as pars plana vitrectomy, led to resolution of the endophthalmitis and recovery of vision to 20/25. Conclusions and importance Fungal endophthalmitis is a rare, potentially blinding complication of cataract surgery. We report our approach to this previously unreported organism, that led to an excellent visual outcome. There are no specific guidelines for fungal endophthalmitis. The management approach has to be tailored to the clinical response and emerging laboratory data from the microbiologist. Identification of the organism will require specialist laboratory references that may not be available in all hospitals. Ophthalmologists must work closely with microbiologists in order to ensure an optimal outcome.
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Affiliation(s)
- Shong Min Voon
- Department of Ophthalmology, Dunedin Public Hospital, 201 Great King Street, Dunedin, 9016, Otago, New Zealand
| | - Arlo Upton
- Southern Community Laboratories, Dunedin, 9016, Otago, New Zealand
| | - Deepak Gupta
- Department of Ophthalmology, Dunedin Public Hospital, 201 Great King Street, Dunedin, 9016, Otago, New Zealand
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Ricci A, Allende A, Bolton D, Chemaly M, Davies R, Girones R, Herman L, Koutsoumanis K, Lindqvist R, Nørrung B, Robertson L, Ru G, Sanaa M, Simmons M, Skandamis P, Snary E, Speybroeck N, Ter Kuile B, Threlfall J, Wahlström H, Cocconcelli PS, Klein G, Prieto Maradona M, Querol A, Peixe L, Suarez JE, Sundh I, Vlak JM, Aguilera-Gómez M, Barizzone F, Brozzi R, Correia S, Heng L, Istace F, Lythgo C, Fernández Escámez PS. Scientific Opinion on the update of the list of QPS-recommended biological agents intentionally added to food or feed as notified to EFSA. EFSA J 2017; 15:e04664. [PMID: 32625421 PMCID: PMC7010101 DOI: 10.2903/j.efsa.2017.4664] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
EFSA is requested to assess the safety of a broad range of biological agents in the context of notification for market authorisation as sources of food and feed additives, food enzymes and plant protection products. The qualified presumption of safety (QPS) assessment was developed to provide a harmonised generic pre-assessment to support safety risk assessments performed by EFSA's scientific Panels. The safety of unambiguously defined biological agents (at the highest taxonomic unit appropriate for the purpose for which an application is intended), and the completeness of the body of knowledge are assessed. Identified safety concerns for a taxonomic unit are, where possible and reasonable in number, reflected as 'qualifications' in connection with a recommendation for a QPS status. The list of QPS recommended biological agents was reviewed and updated in the current opinion and therefore becomes the valid list. The 2016 update reviews previously assessed microorganisms including bacteria, yeasts and viruses used for plant protection purposes following an Extensive Literature Search strategy. The taxonomic units related to the new notifications received since the 2013 QPS opinion, were periodically evaluated for a QPS status and the results published as Statements of the BIOHAZ Panel. Carnobacterium divergens, Lactobacillus diolivorans, Microbacterium imperiale, Pasteuria nishizawae, Pediococcus parvulus, Bacillus flexus, Bacillus smithii, Xanthomonas campestris and Candida cylindracea were recommended for the QPS list. All taxonomic units previously recommended for the 2013 QPS list had their status reconfirmed as well their qualifications with the exception of Pasteuria nishizawae for which the qualification was removed. The exclusion of filamentous fungi and enterococci from the QPS evaluations was reconsidered but monitoring will be maintained and the status will be re-evaluated in the next QPS Opinion update. Evaluation of bacteriophages should remain as a case-by-case procedure and should not be considered for QPS status.
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Abstract
Fungal endophthalmitis is an important cause of vision loss worldwide with a large body of literature describing the treatment of the disease. The evidence supporting the use of pars plana vitrectomy in the management of fungal endophthalmitis is largely comprised of case reports and case series and demonstrates the important role of vitrectomy surgery. Vitrectomy can improve the likelihood of establishing the diagnosis, enhance the treatment of infection by removing fungal elements in the vitreous, aid in the removal of other inoculated intraocular structures, and is an important tool in the management of vision-threatening post-infectious sequelae like retinal detachment and epiretinal membrane.
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Affiliation(s)
- Yewlin E Chee
- a Department of Ophthalmology , University of Wasington , Seattle , WA , USA
| | - Dean Eliott
- b Massachusetts Eye & Ear Infirmary, Harvard Medical School , Boston , MA , USA
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Candida Endophthalmitis. CURRENT FUNGAL INFECTION REPORTS 2014. [DOI: 10.1007/s12281-014-0206-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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