Abstract
This report describes a chronically ill child who presented with high fever and was diagnosed with catheter-related sepsis. Aureobasidium pullulans variety melanigenum, a dematiaceous fungus that rarely causes opportunistic infections, was recovered from multiple blood cultures. Antifungal susceptibilities were performed and the minimum inhibitory concentration (MIC) for fluconazole was 64 mg/l, suggestive of fluconazole resistance. The patient made a full recovery after removal of the catheter line and treatment with liposomal amphotericin B. This is the first case report of an elevated in vitro fluconazole MIC of an A. pullulans isolate and only the third case of successful treatment of A. pullulans fungemia.
Publication types
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Case Reports
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Research Support, U.S. Gov't, Non-P.H.S.
MeSH terms
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Amphotericin B / pharmacology
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Amphotericin B / therapeutic use
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Antifungal Agents / pharmacology
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Antifungal Agents / therapeutic use
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Ascomycota / classification
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Ascomycota / genetics
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Ascomycota / isolation & purification*
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Blood / microbiology
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Catheter-Related Infections / diagnosis
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Catheter-Related Infections / drug therapy
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Catheter-Related Infections / microbiology
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Catheter-Related Infections / pathology
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Child
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DNA, Fungal / chemistry
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DNA, Fungal / genetics
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DNA, Ribosomal Spacer / chemistry
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DNA, Ribosomal Spacer / genetics
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Drug Resistance, Fungal
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Fluconazole / pharmacology
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Fungemia / diagnosis*
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Fungemia / drug therapy
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Fungemia / microbiology*
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Fungemia / pathology
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Humans
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Male
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Microbial Sensitivity Tests
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Molecular Sequence Data
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Mycoses / diagnosis*
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Mycoses / drug therapy
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Mycoses / microbiology*
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Mycoses / pathology
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Sequence Analysis, DNA
Substances
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Antifungal Agents
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DNA, Fungal
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DNA, Ribosomal Spacer
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liposomal amphotericin B
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Amphotericin B
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Fluconazole
Associated data
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GENBANK/GU475133
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GENBANK/GU475134