Primer caso de infección fúngica invasora por Candida fabianii en un paciente pediátrico no neonatal / First report of invasive fungal disease by Candida fabianii in a non-neonatal paediatric patient

Antecedentes. Las enfermedades fúngicas invasoras se han incrementado en los últimos años, y las de especies del género Candida son las de etiología más común. Candida albicans, Candida parapsilosis, Candida tropicalis, Candida glabrata y Candida krusei son las responsables de la mayoría de las infecciones fúngicas. El objetivo de este trabajo es describir el primer aislamiento en sangre de Candida fabianii en un paciente pediátrico no neonatal. Caso clínico. Varón de 2 años de edad con síndrome de intestino corto, malnutrición severa y raquitismo hipofosfatémico carencial, que ingresó en la unidad de cuidados intensivos pediátricos por una infección respiratoria de vías bajas y sospecha de pseudoobstrucción intestinal. Precisó varios ciclos de antibioterapia de amplio espectro por infecciones por Pseudomonas aeruginosa y Escherichia coli. Tras la corrección quirúrgica de su patología intestinal comenzó con un nuevo episodio de sepsis, del que se aislaron levaduras por cultivo. La identificación se realizó mediante espectrometría de masas por el sistema MALDI-TOF (Bruker Daltonic). El resultado obtenido fue el de C. fabianii (anamorfo)/Pichia fabianii (teleomorfo), con un score de 2,149. Se inició un tratamiento antifúngico con caspofungina, con buena evolución del paciente. Conclusiones. Es importante realizar técnicas de biología molecular para la identificación de este tipo de especies, aunque la espectrometría de masas ofreció un diagnóstico fiable y rápido. El tratamiento con caspofungina fue eficaz (AU)

Background. Invasive fungal diseases have increased in recent years. Candida species are the most common aetiology. Candida albicans, Candida parapsilosis, Candida tropicalis, Candida glabrata and Candida krusei are the cause of most of them. The aim of this work is to describe the first isolation of Candida fabianii in the blood of a non-neonatal paediatric patient. Case report. A 2 year-old male with short bowel syndrome, severe malnutrition, and hypophosphataemic rickets deficiency was admitted to paediatric intensive care due to a respiratory tract infection and suspicion of an intestinal pseudo-obstruction. He received several cycles of broad-spectrum antibiotics for several infections due to Pseudomonas aeruginosa and Escherichia coli. After the surgical correction of the intestinal disorder he suffered a new episode of sepsis where yeasts were isolated by culture. The species identification was performed by means of mass spectrometry (MALDI-TOF system, Bruker Daltonic). The identity of the isolate was C. fabianii (anamorph)/Pichia fabianii (teleomorph) with a score of 2.149. Antifungal treatment with caspofungin was prescribed, with good progress of the patient. Conclusions. Molecular techniques are important for the identification of these species, although mass spectrometry offered a reliable and rapid diagnosis. Treatment with caspofungin was effective (AU)

[First report of invasive fungal disease by Candida fabianii in a non-neonatal paediatric patient]. / Primer caso de infección fúngica invasora por Candida fabianii en un paciente pediátrico no neonatal.

BACKGROUND: Invasive fungal diseases have increased in recent years. Candida species are the most common aetiology. Candida albicans, Candida parapsilosis, Candida tropicalis, Candida glabrata and Candida krusei are the cause of most of them. The aim of this work is to describe the first isolation of Candida fabianii in the blood of a non-neonatal paediatric patient. CASE REPORT: A 2 year-old male with short bowel syndrome, severe malnutrition, and hypophosphataemic rickets deficiency was admitted to paediatric intensive care due to a respiratory tract infection and suspicion of an intestinal pseudo-obstruction. He received several cycles of broad-spectrum antibiotics for several infections due to Pseudomonas aeruginosa and Escherichia coli. After the surgical correction of the intestinal disorder he suffered a new episode of sepsis where yeasts were isolated by culture. The species identification was performed by means of mass spectrometry (MALDI-TOF system, Bruker Daltonic). The identity of the isolate was C.fabianii (anamorph)/Pichia fabianii (teleomorph) with a score of 2.149. Antifungal treatment with caspofungin was prescribed, with good progress of the patient. CONCLUSIONS: Molecular techniques are important for the identification of these species, although mass spectrometry offered a reliable and rapid diagnosis. Treatment with caspofungin was effective.