Tüz Mehmet Ali, Ecer Derya Tuna, Atik Tuğba Kula, Yapıcı Oktay
Balikesir University, Medical Faculty, Infectious Diseases and Clinical Microbiology Department, Balikesir, Turkey.
Balikesir University, Medical Faculty, Medical Microbiology Department Balikesir, Turkey.
Rev Inst Med Trop Sao Paulo. 2024 Dec 6;66:e71. doi: 10.1590/S1678-9946202466071. eCollection 2024.
Candida glabrata is a yeast which incidence has increased in recent years and usually causes urogenital and bloodstream infections. Its resistance to fluconazole hinders C. glabrata infections treatment. This case report presents a case of candidemia and scrotal abscess caused by C. glabrata, which was successfully treated with liposomal amphotericin B. The primary treatment options for C. glabrata candidemia are echinocandins and amphotericin B formulations. However, echinocandins and lipid-based amphotericin B formulations do not properly pass through the urinary system. Amphotericin B deoxycholate has a high risk of side effects and is difficult to obtain. The treatment option for candidemia caused by fluconazole-resistant C. glabrata secondary to urinary tract infection is unclear and there are no sufficient studies. For treatment, liposomal amphotericin B may be considered, especially for scrotal and prostatic fluconazole-resistant fungal abscesses. More studies comparing the penetration of antifungals into scrotal and prostatic tissue and the success of antifungal treatment in these tissue infections are needed.
光滑念珠菌是一种近年来发病率有所上升的酵母菌,通常会引发泌尿生殖系统感染和血流感染。它对氟康唑的耐药性阻碍了光滑念珠菌感染的治疗。本病例报告介绍了一例由光滑念珠菌引起的念珠菌血症和阴囊脓肿病例,该病例通过脂质体两性霉素B成功治愈。光滑念珠菌血症的主要治疗选择是棘白菌素类药物和两性霉素B制剂。然而,棘白菌素类药物和基于脂质的两性霉素B制剂不能很好地通过泌尿系统。两性霉素B去氧胆酸盐副作用风险高且难以获得。对于由耐氟康唑的光滑念珠菌继发于尿路感染引起的念珠菌血症的治疗选择尚不清楚,且没有足够的研究。对于治疗,可考虑使用脂质体两性霉素B,特别是对于阴囊和前列腺耐氟康唑的真菌脓肿。需要更多研究来比较抗真菌药物在阴囊和前列腺组织中的渗透情况以及这些组织感染中抗真菌治疗的成功率。