糠马拉色菌是一种亲脂性的,酵母样真菌,构成正常人皮肤菌群的一部分,并与广泛的感染有关,如花色糠疹,毛囊炎,免疫功能低下患者的全身感染。尽管基质辅助激光解吸/电离飞行时间质谱能够快速鉴定马拉色菌,诊断全身性感染仍然是一个挑战,因为自动化血液培养系统通常会错过马拉色菌菌血症.我们报告了一例通过血液涂片中存在酵母样真菌而检测到血液中的M.furfur。在一名3岁男孩的血液涂片中观察到酵母样生物,服用超过2周没有任何症状。他通过留置中心静脉导管(CVC)接受了几个疗程的神经母细胞瘤化疗,该导管放置在他的右前胸部11个月。尽管从自动化血液培养系统获得的血液培养是阴性的,在取自CVC的继代培养的血液中检测到了M.furfur生长。CVC被移除,计划的化疗被推迟了。未发生全身性M.furfur血流感染;感染可自行缓解,无需任何特定治疗;仅给予预防性氟康唑。呋喃M.真菌血症可能无法通过自动血液培养系统诊断。Further,即使静脉内给药,也不会引起人类感染。该报告可能导致将来发现与该疾病的人类传染性相关的因素。
Malassezia furfur is a lipophilic, yeast-like fungus that forms part of the normal human skin microflora and is associated with a wide range of infections, such as pityriasis versicolor, folliculitis, and systemic infections in immunocompromised patients. Although matrix-assisted laser desorption/ionization time-of-flight mass spectrometry has enabled rapid identification of Malassezia species, it is still a challenge to diagnose systemic infections because Malassezia fungemia can often be missed by automated blood culture systems. We report a
case in which M. furfur in blood was detected by the presence of yeast-like fungi in blood smears. Yeast-like organisms were observed in the blood smears of a 3-year-old boy, taken over 2 weeks without any symptoms. He had undergone several courses of chemotherapy for neuroblastoma via an indwelling central venous catheter (CVC) that was placed in his right anterior chest for 11 months. Although the blood cultures obtained from an automated blood culture system were negative, M. furfur growth was detected in the subcultured blood taken from the CVC. The CVC was removed, and the scheduled chemotherapy was postponed. No systemic M. furfur bloodstream infection occurred; the infection resolved spontaneously without any specific treatment; only prophylactic fluconazole was administered. M. furfur fungemia may not be diagnosable by an automated blood culture system. Further, M. furfur may not cause infections in humans even when administered intravenously. This report may lead to the discovery of factors related to human infectivity of this disease in the future.