Case report: nosocomial fungemia caused by Candida diddensiae

Seong Eun Kim,Kyung-Hwa Park,Sook In Jung,Jong Hee Shin,Eun Jeong Won,Yong Jun Choi

doi:10.1186/s12879-020-05095-3

Abstract

BackgroundCandida diddensiae, a yeast found in olive oil, is considered non-pathogenic to humans. Here, we describe the first case of fungemia caused by C. diddensiae in a hospitalized patient with underlying diseases.Case presentationA 62-year-old woman was admitted because of multiple contusions due to repeated falls and generalized weakness. She presented with chronic leukopenia due to systemic lupus erythematosus, and multiple cranial nerve neuropathies due to a recurring chordoma. She was given a lipid emulsion containing total parenteral nutrition (TPN) starting on the day of admission. Broad-spectrum antibiotics had been administered during her last hospital stay and from day 8 of this hospitalization. However, no central venous catheter was used during this hospital stay. Blood cultures obtained on hospital days 17, 23, and 24 yielded the same yeast, which was identified as C. diddensiae via sequence analyses of the internal transcribed spacer region and D1/D2 regions of the 26S ribosomal DNA of the rRNA gene. In vitro susceptibility testing showed that the minimum inhibitory concentration of fluconazole for all isolates was 8 μg/mL. On day 23, TPN was discontinued and fluconazole therapy was started. Blood cultures obtained on day 26 were negative. The fluconazole therapy was replaced with micafungin on day 26 and the patient exhibited improvements.ConclusionThe use of lipid TPN may potentially contribute to the occurrence of nosocomial fungemia by C. diddensiae, an unusual Candida species.

Highlights

Candida diddensiae, a yeast found in olive oil, is considered non-pathogenic to humans
The use of lipid total parenteral nutrition (TPN) may potentially contribute to the occurrence of nosocomial fungemia by C. diddensiae, an unusual Candida species
Candida diddensiae has been considered non-pathogenic to humans but is a component of the olive oil microbiota that affects the quality of the oil [2]

Summary

Introduction

A yeast found in olive oil, is considered non-pathogenic to humans. Conclusion: The use of lipid TPN may potentially contribute to the occurrence of nosocomial fungemia by C. diddensiae, an unusual Candida species. Background Due to an increasing number of patients with impaired immune function and developments in medical interventions, some Candida species previously considered to be food yeasts or harmless commensals are emerging as causes of invasive disease [1].

Results

Conclusion