Central line associated blood stream infection (CLABSI) due to Exophiala dermatitidis in an adult patient: Case report and review

Vila, Andrea; Jahan, Cintia; Rivero, Cynthia; Amadio, Claudio; Ampuero, Adela; Pagella, Hugo

doi:10.1016/j.mmcr.2019.03.001

Cited by 8 publications

(10 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is possible, but not certain, that bloodstream invasion occurred through the Hickmann CVC. Nevertheless, the presence of a CVC may be necessary for E. dermatitidis to establish bloodstream infection as the fungus finds the opportunity to adhere, produce extracellular matrix and grow as biofilm that helps the persistence of fungemia [ 10 ]. It is well known that the prognosis of any rare fungal infection is very poor and this type of infection is often a cause of high mortality although it is not always attributed to fungal infections [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

A fatal neonatal case of fungemia due to Exophiala dermatitidis—case report and literature review

et al. 2022

View full text Add to dashboard Cite

Background Systemic infections caused by the black yeast-like fungus Exophiala dermatitidis are rare, but are associated with high mortality especially in immunocompromised patients. We report the first case of E. dermatitidis fungemia in a premature extremely low birth weight (ELBW) neonate who succumbed despite antifungal therapy with liposomal amphotericin (AMB) and fluconazole. A systematic review of all fungemia cases due to E. dermatitidis was also conducted aiming for a better understanding of the risk factors, treatment strategies and outcomes. Case presentation A male, ELBW premature neonate, soon after his birth, developed bradycardia, apnoea and ultimately necrotizing enterocolitis with intestinal perforation requiring surgical intervention. Meanwhile, he had also multiple risk factors for developing bloodstream infection, such as intubation, mechanical ventilation, central venous catheter (CVC), parenteral nutrition, empirical and prolonged antibiotic use. His blood cultures were positive, firstly for Acinetobacter junii and then for Klebsiella pneumoniae together with E. dermatitidis while on fluconazole prophylaxis and antibiotic empiric therapy. Despite the treatment with broad spectrum antibiotics, liposomal AMB and fluconazole, the newborn succumbed. A literature review identified another 12 E. dermatitidis bloodstream infections, mainly in patients with hematologic malignancies and solid organ transplant recipients (61%), with overall mortality 38% despite CVC removal and antifungal therapy. Conclusions Due to the rarity of E. dermatitidis infections, little is known about the characteristics of this yeast, the identification methods and the optimal therapy. Identification by common biochemical tests was problematic requiring molecular identification. Resolution of neonatal fungemia is difficult despite proper antifungal therapy especially in cases with multiple and severe risk factors like the present one. Therapeutic intervention may include CVC removal and treatment for at least 3 weeks with an azole (itraconazole or fluconazole after susceptibility testing) or AMB monotherapy but not echinocandins or AMB plus azole combination therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

A fatal neonatal case of fungemia due to Exophiala dermatitidis—case report and literature review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Our case is the first reported case of Exophiala dermatitidis fungemia co-infection in COVID-19 pneumonia in a previously healthy individual. Review of reported cases of Exophiala dermatitidis fungemia over the last five years (2017–2021) found one reported outbreak at an outpatient oncology clinic in New York, USA [7] and eight other individual cases throughout the world; mainly from Japan (5 cases) [8] , [9] , [10] , [11] , [12] and one case each from Argentina [13] , India [14] and the United States [15] . For cases that were reported between 2019 and 2021, none of the authors mentioned any association of SARS CoV-2 or COVID-19 disease with Exophiala dermatitidis fungemia ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Exophiala dermatitidis, ‘the real black fungus’ fungemia in a patient with COVID-19

Khaithir

Jamaludin

Wahab

et al. 2022

IDCases

View full text Add to dashboard Cite

The second wave of the COVID-19 pandemic in India had brought with it a surge of ‘black fungus’ co-infection, which is a misnomer for mucormycosis. The present case illustrates the ‘real black fungus’ infection in a 50-year old male patient with COVID-19 pneumonia, who otherwise had no significant previous medical history. He was admitted on day 8 of COVID-19 illness and was intubated due to persistently low oxygen saturation. Blood cultures were positive for flask-shaped dematiaceous budding yeasts with pseudohyphae formation, which grew as brown-black fuzzy colonies on Sabouraud dextrose agar. The isolate was identified as Exophiala dermatitidis based on phenotypic characterization . Despite antifungal therapy with amphotericin B and itraconazole, the patient deteriorated rapidly and succumbed to acute respiratory distress syndrome and multiorgan failure. A review of reported cases of Exophiala dermatitidis fungemia over the last 5-years is discussed.

show abstract

“…E. dermatitidis , an opportunistic, ubiquitously present dematiaceous fungus [ 19 ], is an aetiological agent of three types of infections: superficial, subcutaneous and systemic. The disease spectrum varies from localized cutaneous infection [ 20 ] to disseminated disease, and is referred to as phaeohyphomycosis, which is commonly reported in immunocompromised patients. ‘Phaeo’' in Greek means ‘dark’ and refers to the coloration resulting from the presence of melanin 1,8-dihydroxynaphthalene (a key intermediate required in the synthesis of melanin) in the cell wall of the organism [ 21, 22 ].…”

Section: Discussionmentioning

confidence: 99%

Case report and literature review: double jeopardy – Exophiala dermatitidis and Mycobacterium canariasense central line-associated bloodstream infection in a patient

Ahamad

Tehreem

Farooqi

et al. 2022

Access Microbiology

View full text Add to dashboard Cite

Central line-associated bloodstream infection (CLABSI) is the most common nosocomial-acquired infection, affecting 38 000 patients in the USA annually. Approximately 8–10 % of inserted catheters lead to bloodstream infections, and ~25–30 % of infections are associated with mortality. Although proper line maintenance is essential to prevent infection, it is quite a challenge to avoid infection in patients with a long-term catheter. We present a case of a female in her 40s with a previous history of irritable bowel syndrome (IBS) who has had a central line for total parenteral nutrition for the past 2 years. The patient recently visited the emergency room with fever and generalized fatigue. Blood cultures sent to microbiology were positive for black mould, Exophiala dermatitidis. However, after a few days, microbiology reported an additional micro-organism, Mycobacterium canariasense , a pathogen rarely associated with bacteraemia. The patient was administered voriconazole and moxifloxacin for black mould and mycobacterium infection, respectively. We present an unusual case of rare opportunistic organisms causing bacteraemia and fungaemia in a patient with a long-term catheter. CLABSI remains a serious challenge for clinical facilities. Implementation and monitoring of effective strategies can prevent catheter-related bloodstream infections in patients with long-term catheters and can reduce the morbidity and mortality associated with CLABSI.

show abstract

Central line associated blood stream infection (CLABSI) due to Exophiala dermatitidis in an adult patient: Case report and review

Cited by 8 publications

References 18 publications

A fatal neonatal case of fungemia due to Exophiala dermatitidis—case report and literature review

A fatal neonatal case of fungemia due to Exophiala dermatitidis—case report and literature review

Exophiala dermatitidis, ‘the real black fungus’ fungemia in a patient with COVID-19

Case report and literature review: double jeopardy – Exophiala dermatitidis and Mycobacterium canariasense central line-associated bloodstream infection in a patient

Contact Info

Product

Resources

About