Peritonitis in a neonate due to Cyberlindnera fabianii, an ascomycetic yeast

The ascomycetous yeast Cyberlindera fabianii is not only present in the environment, but is also occasionally pathogenic. Especially, neonates seem to be prone to infection. Here, we describe a case of peritoneal infection of a neonate after congenital heart surgery. The correct identification of th...

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Published inInfection Vol. 45; no. 6; pp. 921 - 924
Main Authors Hof, H., Amann, V., Tauber, C., Paulun, A.
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2017
Springer Nature B.V
Subjects
Amphotericin B
Antifungal agents
Case Report
Caspofungin
Dialysis
Family Medicine
Fluconazole
General Practice
Heart surgery
Identification methods
Infections
Infectious Diseases
Internal Medicine
Kidneys
Medicine
Medicine & Public Health
Molecular biology
Neonates
Newborn babies
Palliation
Peritoneal dialysis
Peritoneum
Peritonitis
Renal insufficiency
Septic shock
Therapy
Yeast
Yeasts
MALDI-TOF
Peritoneal infection
Neonate
Cyberlindnera
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Summary:The ascomycetous yeast Cyberlindera fabianii is not only present in the environment, but is also occasionally pathogenic. Especially, neonates seem to be prone to infection. Here, we describe a case of peritoneal infection of a neonate after congenital heart surgery. The correct identification of this peculiar species is made by MALDI-TOF and especially by molecular biology methods, whereas the standard biochemical identification methods fail.The neonate with a hypoplastic left heart syndrome had a Norwood palliation followed by transient ECMO therapy for 3 days. The patient developed a renal insufficiency, so that peritoneal dialysis was initiated. After a few days, a peritoneal infection due to C. fabianii emerged. The proper source of this rare and particular yeast remains obscure. In spite of a reasonable antimycotic therapy, the patient developed a capillary leak syndrome and died finally in septic shock with multiorgan failure. One reason is probably that the yeast population, which was highly susceptible to all common antimycotic drugs at the beginning of therapy with fluconazole (and for a short period with caspofungin and liposomal amphotericin B), became rapidly resistant.
Bibliography:ObjectType-Case Study-2
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ISSN:0300-8126
1439-0973
DOI:10.1007/s15010-017-1062-8