A rare case of blood stream infection due to Candida ciferii in an immuno-compromised patient

Authors

  • Sonali Choudhari Department of Laboratory Medicine, Microbiology Laboratory, National Cancer Institute, Nagpur, Maharashtra, India
  • Swati Kale Department of Laboratory Medicine, Microbiology Laboratory, National Cancer Institute, Nagpur, Maharashtra, India
  • Anand Pathak Department of Oncology, National Cancer Institute, Nagpur, Maharashtra, India
  • Pradeep Mishra Department of Internal Medicine, National Cancer Institute, Nagpur, Maharashtra, India
  • Girish Deshpande Department of Internal Medicine, National Cancer Institute, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20193298

Keywords:

Acute lymphoblastic Leukaemia, Candida cifferi, Febrile neutropenia

Abstract

Invasive infections related to yeast are increasingly observed in immune-compromised patients in hospitals.Fungal infections have increased morbidity and mortality and prolonged hospital stay which can lead to rise in medical care costs. Non-albicans Candida species have been increasingly found as causative agents in human infections with important therapeutic implications. We present a case of a 37-year-old, female patient, known case of B cell Acute Lymphoblastic Leukaemia admitted in a tertiary care hospital in central India for supportive care and chemotherapy. Patient was responding well to chemotherapy. On post induction day 20, she complained of high-grade fever with abdominal pain.Two sets of blood culture were sent to Microbiology Diagnostic Laboratory for diagnosis. She was started on Injection Magnex Forte (Cefoperazone-Sulbactum) empirically.The Gram stain of positive blood culture showed Gram positive budding yeast like cells in all four bottles.The organism was identified as C. ciferrii on Vitek 2 with 95% identification.Antibiotic susceptibility testing showed sensitive to Amphotericin B MIC ≤0.25 and voriconazole MIC ≤0.12. It was resistant to fluconazole MIC ≥64 μg/ml.

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Published

2019-07-24

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Case Reports