Isolation ofCandida famatafrom a Patient with Acute Zonal Occult Outer Retinopathy

Abstract

The etiology of a number of retinopathies, such as acute zonal occult outer retinopathy (AZOOR), remains undetermined. Candida famata was isolated from conjunctival exudates of a patient diagnosed with AZOOR. This yeast was very abundant, particularly in the more affected eye, while no other pathogens or fungal species were in evidence. Immunological tests revealed the presence of antigen-specific T lymphocytes by using C. famata as a challenge. Moreover, enzyme-linked immunosorbent assay analysis showed the presence of specific antibodies against this yeast in the patient's blood. Delayed hypersensitivity by use of a skin test was also positive. Finally, antifungal treatments led to improvements in several clinical symptoms, including funduscopic analysis. However, despite prolonged treatment with fluconazole and itraconazole, C. famata still appeared in the conjunctival exudates. The new antifungal voriconazole may represent a better choice for treatment.

Fungal Infection in Patients with Serpiginous Choroiditis or Acute Zonal Occult Outer Retinopathy

“…Some of these conditions have been associated with histoplasmosis (8,14). In line with these observations, we reported that AZOOR may be caused by a fungal infection (6). AZOOR was previously considered an immune disorder or a disease caused by an unidentified infectious agent (2,12,18).…”

“…Therefore, simple analysis of yeast growth from blood samples may be misleading. In fact, in a case we reported recently involving an AZOOR patient, C. famata growth was found only twice over a 10-year period (6,30).…”

“…These trials face the problem of reaching high enough concentrations of the antifungal compound in the eye to inhibit C. famata or other fungi present. It is crucial to clarify the fungal etiology of both AZOOR and SC, since present treatments are sometimes based on the use of corticosteroids and other anti-inflammatory compounds (6,13,24,28,39). It is well established that corticosteroids increase susceptibility to fungal infections; indeed, fungal infections are more severe in mice treated with these compounds (25,41).…”

In Vitro Activity of Seven Systemically Active Antifungal Agents against a Large Global Collection of RareCandidaSpecies as Determined by CLSI Broth Microdilution Methods

“…famata (formerly Torulopsis candida; teleomorph, Debaromyces hansenii) has been implicated in fungemia, osteomyelitis, peritonitis, and ocular disease (11,12,87,97,106,110). Infections have been treated successfully by the removal of infected catheters coupled with the administration of either amphotericin B or fluconazole (12,97); however, Quindos et al (87) describe a case of fatal peritonitis in a patient treated with fluconazole, and Wagner et al (106) reported breakthrough fungemia in a patient receiving liposomal amphotericin B and caspofungin for suspected aspergillosis.…”

Contamination of Senior Medical Students’ Cell Phones by Nosocomial Infections: A Survey in a University-Affiliated Hospital in Tehran

“…The increase in the prevalence of fungal infections in patients with immunodeficiency has been prevalent (22)(23)(24) and it has attracted higher attentions in recent decades (25,26). Although, Candida albicans, as the most prevalent cause of candidiasis, is of great importance, recent epidemiologic studies have shown that non-albicans Candida are replacing Candida albicans (22,23,(27)(28)(29)(30) as it is observed that the prevalence of candidemia has increased by 500% from 1980s (25) and more than 1.3% of all infections are caused by non-albicans Candida sp.. Previous studies have shown that candida may be isolated from 15 to 54% of health workers (25).…”