Lopacinski Aaron, Kim Christine, Khreis Mahmoud
Internal Medicine, Eastern Virginia Medical School, Norfolk, USA.
Infectious Disease, Eastern Virginia Medical School, Norfolk, USA.
Cureus. 2023 Feb 16;15(2):e35079. doi: 10.7759/cureus.35079. eCollection 2023 Feb.
is an opportunistic fungus that forms septate hyphae and pseudohyphae, resembling , and causes fungemia in susceptible individuals. Risk factors for infection include immunosuppression, IV catheters, and malignancy. In the present case, a 67-year-old male with a history of renal transplant on immunosuppressive therapy was hospitalized for coronavirus disease 2019 (COVID-19) pneumonia. Despite treatment with steroids and broad initial antibiotic coverage with cefepime, doxycycline, and vancomycin, the patient underwent continual respiratory decline. His sputum culture on hospital day 10 was positive for non-candidal yeast, and despite subsequent appropriate empiric coverage with micafungin and amphotericin B, the patient continued to decline and ultimately died due to the resistance of to these antifungals. This case highlights the importance of suspecting as an infectious cause in patients whose cultures show non-candidal yeast and initiating appropriate antifungal treatment early in their treatment course.
是一种机会性真菌，可形成有隔菌丝和假菌丝，类似于 ，并在易感个体中引起真菌血症。感染的危险因素包括免疫抑制、静脉导管和恶性肿瘤。在本病例中，一名67岁男性有肾移植病史，正在接受免疫抑制治疗，因2019冠状病毒病（COVID-19）肺炎住院。尽管使用了类固醇并最初使用头孢吡肟、强力霉素和万古霉素进行了广泛的抗生素覆盖治疗，但患者的呼吸状况仍持续恶化。他在住院第10天的痰培养显示非念珠菌酵母菌呈阳性，尽管随后使用米卡芬净和两性霉素B进行了适当的经验性覆盖治疗，但患者仍继续恶化，最终因 对这些抗真菌药物耐药而死亡。该病例强调了在培养显示非念珠菌酵母菌的患者中怀疑 作为感染原因的重要性，并在其治疗过程早期启动适当的抗真菌治疗。
