Rhodotorula mucilaginosa associacted meningitis: A subacute entity with high mortality. Case report and review

Abstract

A fatal case of meningitis due to Rhodotorula mucilaginosa in a 28 year-old HIV-negative male with a history of Hodgkin lymphoma who underwent salvage chemotherapy is presented. Reviewing the literature we identified 13 cases with central nervous system infection due Rhodotorula spp. The disease usually occurs in HIV negative immunosupressed middle-aged males. It takes the form of subacute or chronic meningitis accompanied by fever with an overall mortality of 46.2% despite antifungal therapy.

Isolation of Rhodotorula mucilaginosa from blood cultures in a tertiary care hospital

“…The other strains had high MIC values for triazoles. This antifungal susceptibility profile differed from other reports, in which MIC values were lower and heterogeneous . Therefore, in our isolates, voriconazole and itraconazole were not a valid therapeutic alternative.…”

“…This antifungal susceptibility profile differed from other reports, in which MIC values were lower and heterogeneous. 7,11,13 In patients who have previously received azoles with isolation of yeast in blood culture, antifungal therapy with amphotericin B could be started instead of echinocandin in order to a better Rhodotorula spp.…”

“…Rhodotorula is also involved in complicated infections such as endophtalmitis, meningitis and infective endocarditis with high mortality …”

“…4 Rhodotorula species has been also implicated as cause of meningitis, endocarditis, ventriculitis, peritonitis, lymphadenitis, keratitis, prosthetic joint infections and skin infections. [5][6][7] Most infections have been associated with intravenous catheters in patients with solid tumours, chronic renal failure, lymphoproliferative disease, acquired immunodeficiency syndrome, organ transplantation, broad spectrum therapy and invasive medical procedures. 1,8,9 The objective of this retrospective study was to review the isolates in blood cultures of R. mucilaginosa during 5 years in our tertiary care hospital.…”

Analysis of fungal contamination in subways of the metropolitan region of recife-pe, Brazil

“…12 Yeasts of the genus Candida can also cause superficial infections such as onychomycosis, invasive infections such as candidemia, 14 whereas yeasts of the genus Rhodotorula cause invasive infections in immunosuppressed patients. 15 Although there are no data on the occurrence of infectious diseases due to subway use, the microorganisms found in this study may become potential pathogens and may affect the individual who is immunologically debilitated.…”