Candida dubliniensis fungemia in a patient with severe COVID-19: A case report

Ayaka Kakehi, Hideharu Hagiya, Koji Iio, Yasuhiro Nakano, Hiromi Ihoriya, Yuki Taira, Kenta Nakamoto, Kou Hasegawa, Akihito Higashikage, Fumio Otsuka

Research output: Contribution to journalArticlepeer-review

Abstract

Candida dubliniensis phenotypically mimics Candida albicans in its microbiological features; thus, its clinical characteristics have yet to be fully elucidated. Here we report the case of a 68-year-old Japanese man who developed C. dubliniensis fungemia during treatment for severe coronavirus disease 2019 (COVID-19). The patient was intubated and received a combination of immunosuppressants, including high-dose methylprednisolone and two doses of tocilizumab, as well as remdesivir, intravenous heparin, and ceftriaxone. A blood culture on admission day 11 revealed Candida species, which was confirmed as C. dubliniensis by mass spectrometry. An additional sequencing analysis of the 26S rDNA and ITS regions confirmed that the organism was 100% identical to the reference strain of C. dubliniensis (ATCC MYA-646). Considering the simultaneous isolation of C. dubliniensis from a sputum sample, the lower respiratory tract could be an entry point for candidemia. Although treatment with micafungin successfully eradicated the C. dubliniensis fungemia, the patient died of COVID-19 progression. In this case, aggressive immunosuppressive therapy could have caused the C. dubliniensis fungemia. Due to insufficient clinical reports on C. dubliniensis infection based on definitive diagnosis, the whole picture of the cryptic organism is still unknown. Further accumulation of clinical and microbiological data of the pathogen is needed to elucidate their clinical significance.

Original languageEnglish
Pages (from-to)1433-1435
Number of pages3
JournalJournal of Infection and Chemotherapy
Volume28
Issue number10
DOIs
Publication statusPublished - Oct 2022

Keywords

  • Candida dubliniensis
  • Candidemia
  • COVID-19
  • Sequencing analysis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

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