Abstract：
The fungus Wickerhamiella pararugosa (Candida pararugosa) has been detected in various human organs but has rarely caused bloodstream infections. This report presents a case of central venous catheter-related bloodstream infection (CRBSI) of W. pararugosa in an adult. A female patient in her 80s was admitted to our facility for intestinal obstruction caused by colorectal cancer. The patient\'s ability to consume food was hindered, necessitating the insertion of a central venous catheter (CVC) into the internal jugular vein. On day 3 after admission, the patient developed a fever, prompting blood and CVC tip cultures to be performed. On day 5, yeast-like fungi were discovered in the blood cultures, and fosfluconazole (fluconazole [FLCZ] pro-drug) treatment was initiated. On day 8, yeast-like fungi were identified in both the blood and CVC tip cultures, leading to a diagnosis of CRBSI. The fungus was identified as W. pararugosa through biochemical and genetic characterization. This finding justified the use of micafungin (MCFG) for combination therapy. On day 17, the minimum inhibitory concentrations (MIC) for FLCZ and MCFG were 4-8 and 0.06 μg/mL, respectively. Accordingly, the treatment was changed to monotherapy with MCFG. After a 21-day treatment regimen, the patient was discharged on day 31. We present a case of CRBSI caused by W. pararugosa in an adult with intestinal obstruction. The notable increase in the MIC of FLCZ necessitated monotherapy with MCFG, which resulted in successful recovery of the patient.
摘要：
已在各种人体器官中检测到真菌Wickerhamiellapararugosa（念珠菌pararugosa），但很少引起血液感染。本报告介绍了一例成年人的中心静脉导管相关血流感染（CRBSI）。一名80多岁的女性患者因结直肠癌引起的肠梗阻而入院。病人消耗食物的能力受到阻碍，需要将中心静脉导管（CVC）插入颈内静脉。入院后第3天,病人发烧了,提示进行血液和CVC尖端培养。在第5天，在血液培养物中发现了酵母样真菌，并开始氟康唑（氟康唑[FLCZ]前药）治疗。在第8天，在血液和CVC尖端培养物中都鉴定出酵母样真菌，导致CRBSI的诊断。通过生化和遗传表征将真菌鉴定为W.pararugosa。这一发现证明了米卡芬净（MCFG）用于联合治疗的合理性。在第17天，对FLCZ和MCFG的最低抑制浓度（MIC）为4-8和0.06μg/mL，分别。因此，治疗改为MCFG单药治疗.经过21天的治疗方案，患者在第31天出院。我们介绍了一例由成人肠梗阻引起的CRBSI病例。FLCZMIC的显着增加需要MCFG的单药治疗，导致患者成功康复。
