Rhodotorula mucilaginosa skin infection in a patient treated with sorafenib

Abstract

of the species is R. mucilaginosa; it is a ubiquitous pathogen isolated from many sources such as shower curtains, bathtubs, tooth brushes and medical equipments. Before 1985, Rhodotorula was not considered yet as a pathogen, but today it is known to cause significant infections in immunocompromised patients, usually with a malignancy or immunosuppression. Fungemia associated with central venous catheter is the most common consequence of R. mucilaginosa, followed by eye infection (keratitis and endophthalmitis), meningitis, opportunistic onycomycosis and peritonitis. 7,8 Skin infections are extremely rare. Means et al. reported a case of cutaneous R. mucilaginosa treated with photodynamic therapy. 9 Jaeger et al. described a case of R. mucilaginosa folliculitis in Li-Fraumeni-like syndrome. 10 Amphotericin B is considered the gold standard therapy for this infection.Due to the patient's HCC history and chemotherapy with sorafenib, the patient had a higher risk to develop opportunistic infections. We describe the first case of R. mucilaginosa skin infection in a patient with HCC treated with sorafenib.

Rhodotorula species infections in humans: A systematic review

“…No additional studies were found by hand‐screening of the included articles’ references. Finally, 111 met the criteria . Additional information was kindly provided by the corresponding author of one study .…”

A case of cutaneousRhodotorulainfection mimicking cryptococcosis

“…5 Other cases of cutaneous Rhodotorula infection have been reported. 2,3 Our patient is unusual as his infection presented over 30 years post-transplant. It is likely that Rhodotorula was acquired when he recommenced haemodialysis, possibly due to his elbow injury or his central venous catheters.…”

“…Rhodotorula was originally not considered pathogenic, but since the mid‐1980s, infections have been increasingly recognized, possibly because of increasing use of central venous catheters or previous diagnostic difficulties. Rhodotorula infections most frequently present as fungaemia, related to central venous catheters, but ocular infection, meningitis, onychomycosis and peritonitis also occur …”

“…Steroids predispose to yeast fungaemia because of their effects on cellular immunity . Other cases of cutaneous Rhodotorula infection have been reported …”

“…1 Clinical infections have been increasingly recognized since the 1980s; however, infections in solid organ transplant recipients are rare, and cutaneous manifestations seldom reported. 2 We report the case of a renal transplant recipient who developed cutaneous infection with Rhodotorula.…”