The Continuing Emergence of <i>Candida blankii</i> as a Pathogenic Fungus: A New Case of Fungemia in a Patient Infected with SARS-CoV-2
<i>Candida blankii</i> is a recently recognized human pathogen, with most cases of the infection being reported in the immunocompromised. We here describe the case of a critically ill elderly woman with COVID-19 who developed a <i>C. blankii</i> bloodstream infection from a f...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/8/2/166 |
| _version_ | 1797478939495497728 |
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| author | Ryan Mirchin Jonathan M. Czeresnia Erika P. Orner Sudha Chaturvedi Kerry Murphy Joshua D. Nosanchuk |
| author_facet | Ryan Mirchin Jonathan M. Czeresnia Erika P. Orner Sudha Chaturvedi Kerry Murphy Joshua D. Nosanchuk |
| author_sort | Ryan Mirchin |
| collection | DOAJ |
| description | <i>Candida blankii</i> is a recently recognized human pathogen, with most cases of the infection being reported in the immunocompromised. We here describe the case of a critically ill elderly woman with COVID-19 who developed a <i>C. blankii</i> bloodstream infection from a femoral central venous catheter. <i>Aspergillus niger</i> was also isolated from her respiratory secretions. The patient was started on voriconazole for empiric coverage of both <i>A. niger</i>, and at that time, unidentified yeast was found in the blood. Fevers persisted, and the patient expired six days after the yeast was first isolated. Almost one month after her death, <i>C. blankii</i> was identified as the cause of fungemia by sequencing of the internal transcribed spacer (ITS) region of the ribosomal gene and BLAST searching against two databases (performed by a reference laboratory). The isolate demonstrated high minimum inhibitory concentrations (MICs) to azoles and low MICs to amphotericin B, similar to previously described isolates. Timely identification of <i>C. blankii</i> would have prompted different empiric antifungal choices and possibly changed the final outcome. Clinicians should be aware of the pathological potential of <i>C. blankii</i>, the challenges of correctly identifying the organism, and its susceptibility patterns to common antifungals. There is an urgent need to improve assays for <i>C. blankii</i> identification, which will aid in accurate and timely pathogen identification, and appropriate therapeutic management. |
| first_indexed | 2024-03-09T21:38:45Z |
| format | Article |
| id | doaj.art-eb469719212b4b8c99ad2f4b334a3cce |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-09T21:38:45Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-eb469719212b4b8c99ad2f4b334a3cce2023-11-23T20:37:51ZengMDPI AGJournal of Fungi2309-608X2022-02-018216610.3390/jof8020166The Continuing Emergence of <i>Candida blankii</i> as a Pathogenic Fungus: A New Case of Fungemia in a Patient Infected with SARS-CoV-2Ryan Mirchin0Jonathan M. Czeresnia1Erika P. Orner2Sudha Chaturvedi3Kerry Murphy4Joshua D. Nosanchuk5Department of Internal Medicine, New York Presbyterian—Queens, Flushing, NY 11355, USADepartment of Medicine, Division of Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USADepartment of Pathology, Montefiore Medical Center, Bronx, NY 10467, USAWadsworth Center Mycology Laboratory, New York State Department of Health, Albany, NY 12208, USADepartment of Medicine, Division of Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USADepartment of Medicine, Division of Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA<i>Candida blankii</i> is a recently recognized human pathogen, with most cases of the infection being reported in the immunocompromised. We here describe the case of a critically ill elderly woman with COVID-19 who developed a <i>C. blankii</i> bloodstream infection from a femoral central venous catheter. <i>Aspergillus niger</i> was also isolated from her respiratory secretions. The patient was started on voriconazole for empiric coverage of both <i>A. niger</i>, and at that time, unidentified yeast was found in the blood. Fevers persisted, and the patient expired six days after the yeast was first isolated. Almost one month after her death, <i>C. blankii</i> was identified as the cause of fungemia by sequencing of the internal transcribed spacer (ITS) region of the ribosomal gene and BLAST searching against two databases (performed by a reference laboratory). The isolate demonstrated high minimum inhibitory concentrations (MICs) to azoles and low MICs to amphotericin B, similar to previously described isolates. Timely identification of <i>C. blankii</i> would have prompted different empiric antifungal choices and possibly changed the final outcome. Clinicians should be aware of the pathological potential of <i>C. blankii</i>, the challenges of correctly identifying the organism, and its susceptibility patterns to common antifungals. There is an urgent need to improve assays for <i>C. blankii</i> identification, which will aid in accurate and timely pathogen identification, and appropriate therapeutic management.https://www.mdpi.com/2309-608X/8/2/166<i>Candida blankii</i>fungemiaCOVID-19 |
| spellingShingle | Ryan Mirchin Jonathan M. Czeresnia Erika P. Orner Sudha Chaturvedi Kerry Murphy Joshua D. Nosanchuk The Continuing Emergence of <i>Candida blankii</i> as a Pathogenic Fungus: A New Case of Fungemia in a Patient Infected with SARS-CoV-2 Journal of Fungi <i>Candida blankii</i> fungemia COVID-19 |
| title | The Continuing Emergence of <i>Candida blankii</i> as a Pathogenic Fungus: A New Case of Fungemia in a Patient Infected with SARS-CoV-2 |
| title_full | The Continuing Emergence of <i>Candida blankii</i> as a Pathogenic Fungus: A New Case of Fungemia in a Patient Infected with SARS-CoV-2 |
| title_fullStr | The Continuing Emergence of <i>Candida blankii</i> as a Pathogenic Fungus: A New Case of Fungemia in a Patient Infected with SARS-CoV-2 |
| title_full_unstemmed | The Continuing Emergence of <i>Candida blankii</i> as a Pathogenic Fungus: A New Case of Fungemia in a Patient Infected with SARS-CoV-2 |
| title_short | The Continuing Emergence of <i>Candida blankii</i> as a Pathogenic Fungus: A New Case of Fungemia in a Patient Infected with SARS-CoV-2 |
| title_sort | continuing emergence of i candida blankii i as a pathogenic fungus a new case of fungemia in a patient infected with sars cov 2 |
| topic | <i>Candida blankii</i> fungemia COVID-19 |
| url | https://www.mdpi.com/2309-608X/8/2/166 |
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