近几十年来,由罕见的念珠菌引起的感染急剧增加,主要是血液恶性肿瘤。本报告旨在介绍一例副念珠菌血流感染,回顾以前的副梭菌感染病例,并提供临床背景的简要回顾,危险因素,并简要介绍感染的管理。一名有急性髓系白血病病史的3岁男童在奥米德医院住院,伊斯法罕,伊朗。从外周静脉和端口导管取两次连续的血培养;之后,经验性地给予美罗培南。根据常规和分子测定从血液中分离出副念珠菌。此外,确定了分离物的抗真菌药敏谱,对氟康唑(8μg/mL)表现出耐药性。卡泊芬净的抗真菌治疗和去除患者的端口导致了患者病情的显着临床改善。到目前为止,在文献综述中,发现了10例临床上的副丘疹分离株,其中5例患者有血流感染。大多数副梭菌感染患者表现为特定的潜在疾病,比如恶性肿瘤,肉瘤,手术,和成人急性髓细胞性白血病.留置导管的患者有很高的获得副C.pararugosa血流感染的风险。因此,应特别考虑使用导管的免疫功能低下个体的机会性真菌感染。
Infections caused by uncommon Candida species have dramatically increased in recent decades, mostly among hematological malignancies. This report aims to present a case of Candida pararugosa bloodstream infection, review previous cases with C. pararugosa infections, and provide a concise review of the clinical background, risk factors, and brief the management of infections. A 3-year-old boy with a history of acute myeloid leukemia was hospitalized in Omid Hospital, Isfahan, Iran. Two consecutive blood cultures were taken from the peripheral vein and port catheter; after that, empirically meropenem was administered. Candida pararugosa were isolated from blood-based on conventional and molecular assays. Furthermore, the antifungal susceptibility profiles of the isolate were determined, which exhibited resistance to fluconazole (8 μg/mL). Antifungal therapy with caspofungin and removing the patient\'s port led to a significant clinical improvement of the patient\'s conditions. So far, in the literature review, 10 cases of clinical C. pararugosa isolates were found, of which 5 patients had bloodstream infections. Most patients with C. pararugosa infection presented with specific underlying conditions, such as malignancy, sarcoma, surgery, and adult acute myeloid leukemia. Patients with indwelling catheters run a high risk of acquiring C. pararugosa bloodstream infection. Therefore, special consideration should be given to opportunistic fungal infections in immunocompromised individuals using catheters.