Kodamaea Ohmeri Fungemia in an Immunocompetent Patient Treated with Micafungin: Case Report and Review of the Literature

Abstract

Kodamaea (Pichia) ohmeri is an unusual yeast-form fungus that has recently been identified as an important etiology of fungemia, endocarditis, cellulitis, funguria and peritonitis in immunocompromised patients. We report a case of K. ohmeri fungemia in a 34-year-old hospitalized patient with thrombophlebitis. The patient was admitted to the hospital for evaluation and management of an acquired tracheo-esophageal fistula secondary to an impacted denture. Fever developed on hospital day 22, and physical exam revealed right arm superficial thrombophlebitis at the site of the peripheral venous catheter that was confirmed by Doppler ultrasound. The peripheral vein was removed and blood cultures from hospital day 22 and 23 grew yeast species. The yeast was subsequently identified to be K. ohmeri by Vitek II and API20C and was confirmed by 18S rRNA gene sequencing. The fungemia and right arm phlebitis was successfully treated with a 2-week course of micafungin therapy. This is the first case of K. ohmeri fungemia in a patient that was successfully treated with micafungin.

Kodameae ohmeri – An Emerging Yeast: Two Cases and Literature Review

“…The patient group includes neonates and children, immunocompromised cancer patients, patients with other chronic illness such as diabetes as well as immunocompetent patients [1,3,[5][6][7][8][9][10]. A case of fungemia caused by K. ohmeri in a 3-year-old female patient was reported by de Barros et al, from Brazil [9].…”

“…Echinocandins are recently introduced novel antifungal agents and very few studies investigating their clinical efficacy in patients with K. ohmeri infections are available. K. ohmeri fungemia has been successfully treated with caspofungin and micafungin in two cases, suggesting echinocandins as good alternatives [6,26,27].…”

Infection invasive à Kodamaea ohmeri

“…Sur 25 cas décrits dans la littérature, neuf sont décédés (36 %) malgré un traitement antifongique par fluconazole ou amphotéricine B [1]. Il s'agissait essentiellement de fongémies (n = 22) chez des patients immuno-déprimés, qui présentaient des pathologies hématologiques, une prématurité, une affection maligne, une insuffisance rénale chronique ou un dispositif invasif [1].…”

“…Les études microbiologiques confirment l'efficacité constante de l'amphotéricine B [1][2][3]. Les traitements antifongiques décrits reposent principalement sur l'amphotéricine B, le fluconazole ou les échinocandines.…”

Micafungin-Induced Suicidal Erythrocyte Death

“…Micafungin has been employed for the treatment and prophylaxis of diverse fungal infections [1][2][3][4][5][6][7][8][9][10] including candidiasis and aspergillosis [5-8, 12, 15, 24, 27-30, 32, 33, 36, 38, 39]. Side effects of Micafungin treatment include thrombotic thrombocytopenic purpura (TTP), a condition characterized by microangiopathic hemolytic anemia and thrombocytopenia with microvascular thrombosis [40].…”