TY - JOUR
T1 - Candida dubliniensis fungemia in a patient with severe COVID-19
T2 - A case report
AU - Kakehi, Ayaka
AU - Hagiya, Hideharu
AU - Iio, Koji
AU - Nakano, Yasuhiro
AU - Ihoriya, Hiromi
AU - Taira, Yuki
AU - Nakamoto, Kenta
AU - Hasegawa, Kou
AU - Higashikage, Akihito
AU - Otsuka, Fumio
N1 - Funding Information:
We would like to thank Editage (www.editage.jp) for the English language editing.
Publisher Copyright:
© 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
PY - 2022/10
Y1 - 2022/10
N2 - 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.
AB - 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.
KW - Candida dubliniensis
KW - Candidemia
KW - COVID-19
KW - Sequencing analysis
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U2 - 10.1016/j.jiac.2022.07.007
DO - 10.1016/j.jiac.2022.07.007
M3 - Article
C2 - 35863730
AN - SCOPUS:85134834205
SN - 1341-321X
VL - 28
SP - 1433
EP - 1435
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
IS - 10
ER -
