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The Continuing Emergence of Candida blankii as a Pathogenic Fungus: A New Case of Fungemia in a Patient Infected with SARS-CoV-2

Authors :
Ryan Mirchin
Jonathan M. Czeresnia
Erika P. Orner
Sudha Chaturvedi
Kerry Murphy
Joshua D. Nosanchuk
Source :
Journal of Fungi, Vol 8, Iss 2, p 166 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Candida blankii is a recently recognized human pathogen, with most cases of the infection being reported in the immunocompromised. We here describe the case of a critically ill elderly woman with COVID-19 who developed a C. blankii bloodstream infection from a femoral central venous catheter. Aspergillus niger was also isolated from her respiratory secretions. The patient was started on voriconazole for empiric coverage of both A. niger, and at that time, unidentified yeast was found in the blood. Fevers persisted, and the patient expired six days after the yeast was first isolated. Almost one month after her death, C. blankii was identified as the cause of fungemia by sequencing of the internal transcribed spacer (ITS) region of the ribosomal gene and BLAST searching against two databases (performed by a reference laboratory). The isolate demonstrated high minimum inhibitory concentrations (MICs) to azoles and low MICs to amphotericin B, similar to previously described isolates. Timely identification of C. blankii would have prompted different empiric antifungal choices and possibly changed the final outcome. Clinicians should be aware of the pathological potential of C. blankii, the challenges of correctly identifying the organism, and its susceptibility patterns to common antifungals. There is an urgent need to improve assays for C. blankii identification, which will aid in accurate and timely pathogen identification, and appropriate therapeutic management.

Details

Language :
English
ISSN :
2309608X
Volume :
8
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Journal of Fungi
Publication Type :
Academic Journal
Accession number :
edsdoj.b469719212b4b8c99ad2f4b334a3cce
Document Type :
article
Full Text :
https://doi.org/10.3390/jof8020166