Lodderomyces elongisporus
 Masquerading as
 Candida parapsilosis
 as a Cause of Bloodstream Infections

Lockhart, Shawn R.; Messer, S. A.; Pfaller, Michael A.; Diekema, Daniel J.

doi:10.1128/jcm.01790-07

Cited by 94 publications

(109 citation statements)

References 21 publications

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“…elongisporus, named after Dr Jacomina Lodder, is a yeast first described in 1952 as Saccharomyces elongasporus (van der Walt, 1966). It has been isolated in nature from Californian citrus concentrates and the alimentary tract of flower-visiting beetles and other insects and was first described as a bloodstream isolate in 2008 (Ji et al, 2009;Lockhart et al, 2008;Nguyen et al, 2007). This organism was found after a small percentage of isolates confirmed by Vitek and API 20C (bioMérieux) as Candida parapsilosis gave unexpected CHROMagar results.…”

Section: Discussionmentioning

confidence: 99%

“…This organism was found after a small percentage of isolates confirmed by Vitek and API 20C (bioMérieux) as Candida parapsilosis gave unexpected CHROMagar results. These turquoisecoloured colonies were further characterized and identified as L. elongisporus by 26S rRNA gene sequencing (Lockhart et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…Now, L. elongisporus needs to be additionally differentiated from the complex (Lin et al, 1995;Tay et al, 2009). Characteristically, L. elongisporus produces short pseudohyphae on cornmeal agar and produces single large round ascospores in Saccharomyces sporulation medium (Lockhart et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…These were tested by various methods including broth microdilution (Antifungal Susceptibility Testing Subcommittee of the European Committee on Antibiotic Susceptibility Testing for testing fermentative yeasts) and Etest (AB Biodisk) (Cuenca-Estrella et al, 2006;Tay et al, 2009). All isolates described so far have been fluconazolesensitive (Lockhart et al, 2008). This is not necessarily the case with other uncommonly identified non-albicans Candida species (Cuenca-Estrella et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

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Lodderomyces elongisporus endocarditis in an intravenous drug user: a new entity in fungal endocarditis

Daveson

Woods

2012

Journal of Medical Microbiology

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Lodderomyces elongisporus has been recently identified in the literature as an infrequent human bloodstream isolate, commonly mistaken for a non-albicans Candida. A case of Lodderomyces endocarditis in an intravenous drug user is described. To our knowledge, this report highlights the first documented case of Lodderomyces as a cause of endocarditis and summarizes the susceptibility patterns in the reported literature. All isolates reported so far have fluconazole MICs of ¡0.25 mg ml "1 . Case reportA 30-year-old male carpenter presented febrile to a hospital emergency department with associated recurrent swelling of his left forefoot. He had experienced a week of night sweats and rigors and no history of foot trauma. He had sought medical treatment in primary care for his foot symptoms in the preceding weeks prior to the commencement of the night sweats. The presumptive diagnosis had been a soft tissue injury and was treated symptomatically with no improvement.His past medical history included depression and claustrophobia. He was known to have a pre-existing cardiac murmur that had never been investigated. He was an intravenous heroin user, cigarette smoker and social drinker. He injected primarily via his left cubital fossa and occasionally the venous networks on the dorsal surfaces of his hands. He last admitted to intravenous drug use 8 weeks prior to presentation. His medications included oral quetiapine and he had no allergies.Vital signs on admission were as follows: temperature 38.4 u C, pulse rate regular at 102 beats min 21 , blood pressure of 102/ 74 and respiratory rate of 18 respirations min 21 . Examination revealed an ejection systolic murmur and oedema localized to the left ankle region associated with full range of movement. There were no peripheral stigmata of endocarditis, neurological abnormalities or cardiac failure.Three sets of blood cultures in addition to standard bloods were taken from two different sites (BacT/ALERT; bioMérieux). The aerobic bottles of all sets flagged positive after approximately 40 h (range 37.6-43.8 h). Yeast was seen on microscopy. Preliminary identification was that of a non-albicans Candida after growth on Sabouraud Dextrose Agar, a negative germ tube test and subsequent isolation of blue/green colonies on CHROMagar Candida media (BD Diagnostics). The isolate was referred to a reference laboratory for definitive identification. A further two sets of blood cultures taken 2 days later also flagged positive prior to the commencement of antifungal agents. He was empirically commenced on caspofungin whilst awaiting further investigations and results. Blood cultures taken 48 h after therapy was commenced had no growth.A transoesophageal echo was performed and demonstrated a bicuspid aortic valve with mild stenosis and aortic regurgitation. Bulky lesions up to 1 cm were attached to both leaflet margins. An MRI of his brain revealed right frontal and left parietal hyperintense lesions on the T2 weighted images consistent with presumed embolic lesions. A bone scan was con...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Lodderomyces elongisporus endocarditis in an intravenous drug user: a new entity in fungal endocarditis

Daveson

Woods

2012

Journal of Medical Microbiology

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“…L. elongisporus is an unusual causative organism of bloodstream infections in humans and has been isolated from Asia and Mexico (4,5). L. elongisporus was also reported as the causative organism of endocarditis (6).…”

mentioning

confidence: 99%

Catheter-Related Bloodstream Infection Due to Lodderomyces elongisporus

et al. 2016

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SUMMARY: Lodderomyces elongisporus infrequently causes bloodstream infections and has been isolated from Asia and Mexico. We encountered a catheter-related bloodstream infection, which involved some risk factors, due to L. elongisporus masquerading as Candida parapsilosis. A 39-year-old man who received a total arch and thoracoabdominal aortic replacement was admitted with a diagnosis of aorto-esophageal fistula. After thoracic drainage for the aorto-esophageal fistula, a catheter-related bloodstream infection was diagnosed. Micafungin (100 mg/day) was successfully administered to treat the catheter-related bloodstream infection for 42 days in total. The bloodstream and catheter tip yeast was grown on Candida agar medium and produced dark green colonies indicating Candida albicans. We performed sequencing analysis using a GenBank BLAST search. The sequence of the internal transcribed spacer region was 99.9z identical with that of the type strain L. elongisporus. This yeast organism has frequently been technically mistaken for non-albicans Candida spp. Furthermore, the prognosis and risk factors of L. elongisporus infection remain unclear owing to the scarcity of reported cases. Catheter-related bloodstream infection caused by this organism has not been described to date.

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Discovery of Extant Sexual Cycles in Human Pathogenic Fungi and Their Roles in the Generation of Diversity and Virulence

Bennett

Nielsen²

2012

Evolution of Virulence in Eukaryotic Microbes

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Lodderomyces elongisporus Masquerading as Candida parapsilosis as a Cause of Bloodstream Infections

Cited by 94 publications

References 21 publications

Lodderomyces elongisporus endocarditis in an intravenous drug user: a new entity in fungal endocarditis

Lodderomyces elongisporus endocarditis in an intravenous drug user: a new entity in fungal endocarditis

Catheter-Related Bloodstream Infection Due to <i>Lodderomyces elongisporus</i>

Discovery of Extant Sexual Cycles in Human Pathogenic Fungi and Their Roles in the Generation of Diversity and Virulence

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