China 
Africa 
Explore chapters and articles related to this topic
Bloodstream Infections
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Fungi are another cause of BSI. This is called fungaemia. The most common causes of fungaemia are yeasts. The most common yeasts involved are Candida albicans and non-albicans species such as C. glabrata, C. parapsilosis, C. krusei and C. tropicalis. Candida auris is an emerging multidrug-resistant Candida of international concern. Blood cultures are only positive in 50% of candidaemia. To rule out a candidaemia, it is useful to test the fungal biomarker (1–3)-β-d-glucan (BDG). A negative BDG has a high negative predictive value (see Chapter 4.32). Other yeasts involved are Cryptococcus spp. and Histoplasma capsulatum. Cryptococcal fungaemia is strongly associated with HIV. Most moulds do not grow in blood cultures; exceptions are Fusarium spp. and, less commonly, Aspergillus terreus.
Cryptococcus
Published in Rossana de Aguiar Cordeiro, Pocket Guide to Mycological Diagnosis, 2019
Luciana Trilles, Márcia dos Santos Lazéra, Bodo Wanke
Primary skin lesion by traumatic inoculum is rare and may occur due to laboratory accidents and direct trauma (Neuville et al., 2003). Cryptococcemia or cryptoccocal fungemia may present with fever, tremors, and chills in individuals with high fungal burden that can be revealed by blood culture. Cryptococcal peritonitis occurs in individuals undergoing peritoneal dialysis or with hepatic cirrhosis. Other sites can also be infected, although less frequently, such as the subcutaneous tissue, muscle, heart, adrenal gland, thyroid, gastrointestinal tract, and lymph nodes. Infection in the genitourinary tract is usually asymptomatic, but pyelonephritis may occur, especially in diabetic patients. The elimination of the fungus by the urine is frequently observed in cases of fungemia and can be detected by culture exam (Pinto-Junior et al., 2006).
Epidemiology of fungal infections: What, where, and when
Published in Mahmoud A. Ghannoum, John R. Perfect, Antifungal Therapy, 2019
Frederic Lamoth, Sylvia F. Costa, Barbara D. Alexander
Saccharomyces cerevisiae is a yeast used in the food industry for beers, wines and bakery products, and it is also part of the normal flora of the gastrointestinal tract, respiratory tract, and vaginal mucosa. Saccharomyces boulardii, which is now considered as a variety of S. cerevisiae, is used in probiotics for the prevention or treatment of antibiotic-related diarrhea. Saccharomyces fungemia has been increasingly reported during the last decade and has been associated with the use of probiotics [496]. In addition to translocation from the gastrointestinal tract, intravenous cather infection can also be a port of entry. Fungemia may occur in immunocompromised as well as immunocompetent patients. In a review of 60 cases of S. cerevisiae fungemia, 60% of patients were in the ICU, 71% were receiving enteral or parenteral nutrition, 93% had a central venous catheter and 88% were receiving broad-spectrum antibacterial therapy and the use of probiotics was reported for 46% [496]. In addition to fungemia, other clinical presentations of S. cerevisiae infections include: endocarditis, liver abscess, esophagitis, peritonitis, pneumonia or empyema, urinary tract infection and vaginitis [496,497]. The presence of antibodies to S. cerevisiae has also been associated with Crohn disease [498].
Updates on the profile of GenMark’s ePlex blood culture identification fungal pathogen panel
Published in Expert Review of Molecular Diagnostics, 2023
Masako Mizusawa, Karen C Carroll
Use of blood samples is ideal for diagnostic assays of IFDs as the risk of venipuncture is minimal and presence of fungi in blood usually suggests true infection. Commercial molecular-based multiplex panels that test positive blood cultures based upon the presence of fungal elements visualized on Gram stain, such as the ePlex BCID-FP Panel are easy-to-use, require minimal hands-on time and can provide definitive diagnosis of fungemia in a short turnaround time. The costs of those assays are higher than conventional methods, but the costs may be off-set by earlier targeted therapy and improved clinical outcomes. As highlighted in this review, several studies have demonstrated earlier treatment modifications in up to 45% of patients using the ePlex BCID-FP assay. However, the sensitivity of blood cultures for diagnosis of IFDs is limited and the time required for fungal growth in blood cultures cannot be shortened. It is also impossible to create an exhaustive fungal pathogen panel as potential pathogens of fungemia include a variety of saprophytic and environmental fungi and new emerging fungal pathogens continue to be discovered.
Bendamustine treatment of haematological malignancies: significant risks of opportunistic viral, fungal and bacterial infections
Published in Hematology, 2022
Tony K.Y. Wu, Karen H.K. Tang, Yu-Yan Hwang, Thomas S.Y. Chan, Eric Tse, Yok-Lam Kwong
IFD was found in five patients. Notably, four patients received bendamustine as first-line treatment. IFD is unusual in patients with lymphoid malignancies undergoing first-line chemotherapy, so that anti-fungal prophylaxis is considered unnecessary [24]. However, bendamustine appears to have increased the risk of IFD. In two patients not receiving anti-fungal prophylaxis, yeast fungemia occurred. One patient had cryptococcemia, a condition typically found only in immunocompromised patients [25]. Arguably, this case might have been prevented with a simple azole such as fluconazole. In the three cases receiving anti-fungal prophylaxis, breakthrough IFDs might be caused by inherently resistant fungi. Two patients receiving echinocandin prophylaxis developed pulmonary mould infection. The rate of breakthrough invasive mould infections including invasive aspergillosis was about 5–7% in patients receiving echinocandins [26]. The third patient receiving itraconazole prophylaxis developed Candida parapsilosis fungemia. In in vitro studies, the sensitivities of Candida parapsiolosis isolates to posaconazole and voriconazole were 100% and 99%, whereas that to itraconazole was only 89% [27]. As this was the patient with CMV duodenitis/colitis where a breach of mucosal defence and multiple risk factors for IFD were found, in retrospect a more potent azole such as posaconazole or isavuconazole ought to have been used in this case.
Ocular Involvement in Patients with Fungemia in an Urban Tertiary Care Center
Published in Ocular Immunology and Inflammation, 2019
Kenneth W. Price, Edmund Tsui, Irene Barbazetto, Lisa Park
High rates of fungemia are commonly seen in hospitalized patients with risk factors including diabetes mellitus, intravenous drug use, indwelling lines, hyperalimentation, cancer chemotherapy, bone marrow transplantation, AIDS, and recent major surgery, especially gastrointestinal surgery.5–12 Early studies from before 1990 demonstrated the incidence of endogenous fungal endophthalmitis in patients with disseminated fungemia to range from 28% to 37%.6,13 The most common pathologic organism in studies included Candida albicans and Candida tropicalis.13 Because of these findings, dilated fundus examination was recommended for all patients with blood cultures positive for Candida spp. More recently, a decreasing prevalence of ocular involvement has been observed presumably due to increased clinical awareness, improved antifungal therapy, and prompt systemic treatment once positive fungal blood cultures are detected.14 Current estimates of endogenous fungal endophthalmitis range between 0% and 28% with the most recent prospective study showing a prevalence of 5.6%.6–8,15–21 These rates vary greatly due to the rarity of disease.