Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Ann Lab Med. 2012 May;32(3):225-8. doi: 10.3343/alm.2012.32.3.225. Epub 2012 Apr 18.
Candidemia due to uncommon Candida spp. appears to be increasing in incidence. C. dubliniensis has been increasingly recovered from individuals not infected with HIV. Identification of C. dubliniensis can be problematic in routine clinical practice due to its phenotypic resemblance to C. albicans. We report the first case of C. dubliniensis candidemia in Korea, which occurred in a 64-yr-old woman who presented with partial seizure, drowsiness, and recurrent fever. Germ-tube positive yeast that was isolated from blood and central venous catheter tip cultures formed smooth, white colonies on sheep blood agar and Sabouraud agar plates, indicative of Candida spp. C. dubliniensis was identified using the Vitek 2 system (bioMerieux, USA), latex agglutination, chromogenic agar, and multiplex PCR. The blood isolate was susceptible to flucytosine, fluconazole, voriconazole, and amphotericin B. After removal of the central venous catheter and initiation of fluconazole treatment, the patient's condition gradually improved, and she was cleared for discharge from our hospital. Both clinicians and microbiologists should be aware of predisposing factors to C. dubliniensis candidemia in order to promote early diagnosis and appropriate treatment.
不常见的念珠菌属引起的念珠菌血症的发病率似乎正在上升。从未感染 HIV 的个体中越来越多地分离出杜波依斯念珠菌。由于其表型与白色念珠菌相似,因此在常规临床实践中鉴定杜波依斯念珠菌可能存在问题。我们报告了韩国首例杜波依斯念珠菌血症病例,该病例发生在一名 64 岁女性患者中,其表现为部分性癫痫发作、嗜睡和反复发热。从血液和中心静脉导管尖端培养物中分离出的芽管阳性酵母在绵羊血琼脂和沙氏琼脂平板上形成光滑的白色菌落,提示为念珠菌属。使用 Vitek 2 系统(法国生物梅里埃公司)、乳胶凝集、显色琼脂和多重 PCR 鉴定为杜波依斯念珠菌。血培养分离株对氟胞嘧啶、氟康唑、伏立康唑和两性霉素 B 敏感。在拔除中心静脉导管并开始氟康唑治疗后,患者的病情逐渐好转,获准出院。临床医生和微生物学家都应该了解杜波依斯念珠菌血症的易患因素,以便促进早期诊断和适当治疗。