Setoguchi Daichi, Iwanaga Naoki, Ito Yuya, Hirayama Tatsuro, Yoshida Masataka, Takeda Kazuaki, Ide Shotaro, Nagayoshi Yohsuke, Kondo Akira, Tashiro Masato, Takazono Takahiro, Kosai Kosuke, Izumikawa Koichi, Yanagihara Katsunori, Mukae Hiroshi
Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
Department of Respiratory Medicine, NHO Nagasaki Medical Center, Nagasaki, Japan.
Heliyon. 2024 May 19;10(10):e31464. doi: 10.1016/j.heliyon.2024.e31464. eCollection 2024 May 30.
is a recently discovered and not widely documented ascomycetous yeast phylogenetically related to the outbreak-causing and multidrug-resistant . A middle-aged Japanese man with no discernible immunodeficiency was admitted to hospital with ileal diverticulitis. Following laparoscopic right hemicolectomy against abscess formation on postoperative day (POD) 7, continuous fungemia occurred due to identified using a conventional method by confirming the biochemical phenotype. Micafungin was initiated; however, the fungus was persistently isolated from blood cultures. Eventually, the antifungal agent was changed to a combination of liposomal amphotericin B (L-AMB) and caspofungin (CPFG), which cleared the infection, and no pathogens were detected in the blood cultures on POD 31. Contrast-enhanced computed tomography showed septic emboli in the lungs and spleen; however, no evidence of vasculitis was observed. Moreover, sequential echocardiography did not reveal any signs of infectious endocarditis. Finally, CPFG and L-AMB were administered to the patient for 7 and 9 weeks, respectively, during which the patient's symptoms did not relapse. The strain was later genetically identified as . This case report illustrates a clinical presentation of and provides the diagnostic approach and treatment methods for this pathogen.
是一种最近发现且文献记载不多的子囊菌酵母,在系统发育上与引起暴发和多重耐药的[相关菌]有关。一名无明显免疫缺陷的中年日本男性因回肠憩室炎入院。术后第7天(POD 7)因形成脓肿行腹腔镜右半结肠切除术,采用传统方法通过确认生化表型鉴定出[该菌],随后发生持续性真菌血症。开始使用米卡芬净治疗;然而,该真菌在血培养中持续分离出来。最终,抗真菌药物改为脂质体两性霉素B(L-AMB)和卡泊芬净(CPFG)联合使用,感染得以清除,POD 31时血培养未检测到病原体。增强CT显示肺部和脾脏有脓毒性栓子;然而,未观察到血管炎的证据。此外,连续超声心动图未发现感染性心内膜炎的任何迹象。最后,分别给患者使用CPFG和L-AMB 7周和9周,在此期间患者症状未复发。该菌株后来经基因鉴定为[该菌]。本病例报告阐述了[该菌]的临床表现,并提供了针对该病原体的诊断方法和治疗手段。