Exophiala dermatitidis as a cause of central line associated bloodstream infection in an infant: Case report and literature review |
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| Authors: | Anil Kumar Aswathy Nandakumar Sajitha Nair Ashutosh Singh Nandita Shashindran Swathy Thulasidharan Kiran Subhash Arya Ramachandran Anuradha Chowdhary |
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| Institution: | 1. Department of Microbiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ponekkara, Kerala, India;2. Department of Paediatrics, Amrita Institute of Medical Sciences, Amrita University, Ponekkara, Kerala, India;3. Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, India |
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| Abstract: | BackgroundExophiala dermatitidis is a dematiaceous fungus known to cause superficial, subcutaneous, cutaneous and deep seated infections, and rarely central line associated bloodstream infection (CLABSI). A case of CLABSI due to E. dermatitidis in an infant is described.Case reportClinical and laboratory data were extracted from patient's chart and laboratory records. The isolate was identified as E. dermatitidis by phenotypic characterization and sequencing of the ITS and LSU regions of the ribosomal DNA. Medline search was done to review all cases of CLABSI due to E. dermatitidis. Among the azoles tested, posaconazole (0.06 mg/l), voriconazole (0.03 mg/l) and itraconazole (0.03 mg/l) showed very low MICs when compared to fluconazole (4 mg/l)ConclusionsAs we did not found in the literature any case of CLABSI due to E. dermatitidis in an infant, we report the first one. Sequencing is a mandatory method for accurately identifying this species. Prompt removal of the central line, followed by a treatment with amphotericin B or an azole, seems to be the most effective treatment. |
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| Keywords: | Fungemia Central line Infant Phaeohyphomycosis Fungemia Catéter central Lactante Feohifomicosis |
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