Peritonitis terciaria por Candida famata: infección por una levadura atípica / Tertiary peritonitis due to Candida famata: Infection by an atypical yeast

ResumenLa Candida famata es una levadura halotolerante, sobreproductora de vitamina B2, asociada infrecuentemente a infecciones en seres humanos, cuyo uso es común en procesos industriales. En nuestro servicio, se había detectado un único caso en el contexto de mediastinitis con un desenlace mortal. Se carecía de experiencia en cuanto al manejo de la infección por este agente. Posterior a una exhaustiva revisión bibliográfica, se demuestra la ausencia de reportes de infecciones por este agente en el contexto de la peritonitis terciaria. Se reporta el caso de un paciente de 37 años de edad que sufrió una herida de arma blanca en abdomen, y que después de múltiples complicaciones asociadas a este evento, desarrolló una peritonitis terciaria por C. famata; fue tratado satisfactoriamente con caspofungina y un abdomen abierto con terapia de presión negativa e instilación. Se espera que esta experiencia sirva de referente al detectar algún paciente con esta condición en el futuro.

AbstractCandida famata is a halotoleran, vitamin B2 overproducing yeast that is rarely associated with infections in humans, but is commonly utilized in industrial processes. In our service, it had been detected only once before in a patient with mediastinitis. The outcome of that infection was fatal. Not only were we unfamiliar with the management of infection by this agent, but after performing a thorough literary review, we were unable to find published reports of infections by this pathogen as the cause of tertiary peritonitis. We report the case of a 37 year old male who after suffering a stab wound to his abdomen and having multiple complications associated with this event, developed tertiary peritonitis by C. famata, that was treated with casponfungin and an open abdomen utilizing negative pressure wound therapy with instillation which yielded a satisfactory response to the therapy. This report may be of use in the event that clinicians are confronted with this condition in the future.

Candida famata Infection Presenting as an Erosive Patch on the Sole of an Immunocompetent Patient / 대한피부과학회지

Candida famata previously called Torulopsis famata or Debaryomyces hansenii, is usually found in natural substrates. It was earlier considered nonpathogenic in humans; however, a number of clinical cases of human infection have been reported showing isolation of this yeast. Dermatologic literature contains only a few reports regarding cutaneous infection caused by Candida famata. An 18-year old woman presented with a 4-month history of a 4.0×3.0 cm sized erythematous erosive patch on her left sole. A skin biopsy revealed numerous spores and hyphae in the epidermis. Histopathological specimens showed positive findings using the Periodic acid-Schiff and Gomori methenamine silver stains but negative findings using acid-fast bacilli stain. Cultures from skin scrapings yielded numerous colonies. Identification of the fungus was processed up to species level using VITEK 2 (bioMérieux, Inc. Hazelwood, MO, USA), and Candida famata was isolated. She was administered itraconazole at a dose of 200 mg once daily, and following 5 weeks of therapy, the erosive lesion was noted to have completely healed with postinflammatory hyperpigmentation.

Etiologia dos casos de candidíase cutânea atendidos no serviço de micologia da Universidade Federal Fluminense, Brasil / Etiología de casos de candidiasis cutánea atendidos en el servicio de micología de la Universidad Federal Fluminense, Brasil / Etiology of cutaneous candidiasis cases seen at the mycology service of the Universidade Federal Fluminense, Brazil

Neste trabalho foram estudadas 64 amostras oriundas de 56 pacientes com suspeita clínica de candidíase cutânea, coletadas de novembro de 2008 a agosto de 2009, no serviço de Diagnóstico Micológico Humano e Veterinário do Departamento de Microbiologia e Parasitologia, Instituto Biomédico da Universidade Federal Fluminense. Foram isoladas espécies de Candida em 58 amostras de 51 pacientes, trinta e oito mulheres e treze homens, com a seguinte distribuição: 15 C. parapsilosis, 11 C. famata, 9 C. albicans, 7 C. haemulonii, 5 C. ciferrii, 4 C. guilliermondii, 4 C. lipolytica e 3 C . tropicalis. As onicomicoses representaram mais de 75% das manifestações clínicas. Nos casos em que não foi Candida isolada como o agente etiológico, foram identificados dois Cryptococcus laurentii, um Trichosporon mucoides e um Trichosporon asahii. Este trabalho é uma contribuição para o entendimento da etiologia de candidíase cutânea no serviço de Micologia da Universidade Federal Fluminense.

En este trabajo se estudiaron 64 muestras procedentes de 56 pacientes con sospecha clínica de candidiasis cutánea, recolectadas entre noviembre de 2008 a agosto de 2009 en el servicio de Diagnóstico Micológico Humano y Veterinario del Departamento de Microbiología y Parasitología, Instituto Biomédico de la Universidad Federal Fluminense. Se aislaron especies del género Candida en 58 muestras de 51 pacientes, treinta y ocho mujeres y trece hombres, con la siguiente distribución: 15 C. parapsilosis, 11 C. famata, 9 C. albicans, 7 C. haemulonii, 5 C. ciferrii, 4 C. guilliermondii, 4 C. lipolytica y 3 C . tropicalis. Las onicomicosis representaron más del 75% de las manifestaciones clínicas. En los casos donde no se aisló Candida como agente etiológico se identificaron dos Cryptococcus laurentii, un Trichosporon mucoides y un Trichosporon asahii. Este trabajo es una contribución al conocimiento de la etiología de la candidiasis cutánea en el Servicio de Micología de la Universidad Federal Fluminense.

This work corresponds to the study of 64 samples from 56 patients with clinical suspicion of cutaneous candidiasis, collected between November 2008 and August 2009 at the Human and Veterinarian Diagnostic Service of the Department of Microbiology and Parasitology of the Instituto Biomédico of the Universidad Federal Fluminense, Brazil. Candida genus species were isolated in 58 samples from 51 patients (38 women and 13 men), with the following distribution: C. parapsilosis 15, C. famata 11, C. albicans 9, C. haemulonii 7, C. guilliermondii 4, C. ciferrii 5, C. lipolytica 4, and C. tropicalis 3. Onicomycoses represented over 75% of the clinical manifestations. In cases where Candida was not isolated as etiologic agent, two Cryptococcus laurentii, one Trichosporum mucoides, and one Trichosporum asahii were identified. This work is a contribution to the knowledge of the etiology of cutaneous candidiasis at the Mycology Service of the Universidade Federal Fluminense.

Productividad y selectividad del medio de cultivo a partir de guayaba agria (psidium araca) en el crecimiento de levaduras nativas del género candida sp / Productivity and selectivity of culture medium from the sour guava (psidium araca) in the growth of native yeast candida sp

El presente trabajo se llevó a cabo para evaluar la eficiencia del medio de cultivo a partir de guayaba agria (Psidium araca) frente a medios comerciales en el crecimiento de tres cepas nativas: Candida guillermondii, Candida famita y Candida sp. Se evaluó el crecimiento microbiano a diferentes concentraciones de fruta, 5, 10, 25 y 50% p/v, tomando como control los medios comerciales: Malta, Sabouraud y agar papa dextrosa (PDA). La productividad y selectividad del medio de guayaba agria fue determinada mediante el método Ecométrico en un tiempo de 48 horas. Los análisis estadísticos aplicados para evaluar y comparar el crecimiento de las cepas en los medios comerciales y en el medio de guayaba agria a diferentes concentraciones demostraron lo siguiente: Candida guillermondii presentó crecimiento mayor o igual a 25 y 50% p/v comparado con los medios comerciales; Candida famata y Candida sp presentaron mejores crecimientos al 5% p/v, con respecto a los diferentes medios comerciales. Los resultados demostraron que el medio de cultivo es altamente productivo y no selectivo, lo que representa una alternativa en la conservación, el mantenimiento y el desarrollo de las levaduras estudiadas.

This work was carried out to evaluate the efficiency of the culture medium from sour guava (Psidium araca) against commercial media in the growth of three native strains: Candida guillermondii, Candida famata and Candida sp. Microbial growth was evaluated at different concentrations of fruit, 5, 10, 25, 50% w /v, using as control the commercial media: Malta, Sabouraud and PDA (Potato Dextrose Agar). The productivity and selectivity of the sour guava medium was determined by the Ecometric method in a time of 48 hours. The applied statistical analysis to evaluate and compare growth of strains in commercial culture medium and in the medium from sour guava at different concentrations showed: Candida guillermondii grew greater than or equal to 25 and 50% w / v compared with commercial medium, Candida famata and Candida sp showed better growth at 5% w / v, with respect to commercial medium. The results showed that the medium is highly productive and non-selective representing an alternative to the conservation, maintenance and development of the yeasts.