학술논문
Candida parapsilosis bone marrow infection in an immunocompetent patient.
Document Type
Report
Author
Edwards NJ; Department of General Medicine, Monash Health, Clayton, Victoria 3168, Australia.; Department of Emergency Medicine, Western Health, Footscray, Victoria 3011, Australia.; La PBD; Department of General Medicine, Monash Health, Clayton, Victoria 3168, Australia.; Abasszade JH; Department of General Medicine, Monash Health, Clayton, Victoria 3168, Australia.; Department of General Medicine, Northern Health, Epping, Victoria 3076, Australia.; Abrahams T; Department of General Medicine, Monash Health, Clayton, Victoria 3168, Australia.; Nan K; Department of General Medicine, Monash Health, Clayton, Victoria 3168, Australia.; Tinson AJ; Department of General Medicine, Northern Health, Epping, Victoria 3076, Australia.; Department of General Medicine, Austin Health, Heidelberg, Victoria 3084, Australia.; Tedjaseputra A; Monash Haematology, Monash Health, Clayton, Victoria 3168, Australia.; Wu MN; Department of General Medicine, Monash Health, Clayton, Victoria 3168, Australia.
Source
Publisher: Elsevier Ltd Country of Publication: Netherlands NLM ID: 101634540 Publication Model: eCollection Cited Medium: Print ISSN: 2214-2509 (Print) Linking ISSN: 22142509 NLM ISO Abbreviation: IDCases Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2214-2509
Abstract
Background: We discuss a case of an immunocompetent patient who presented with fever and tachypnoea, found to have Candida parapsilosis bone marrow infection, cultured on bone marrow aspirate sample. Candida parapsilosis is an opportunistic yeast pathogen that typically affects immunocompromised individuals, or occurs in patients with apparent introduced source; neither of these factors were present for this case. Bone marrow aspirates and trephines are not regular investigations for fever; however they can be useful diagnostic aids as evidenced in this case.
Case Report: An 83-year-old woman presenting with fevers and tachypnoea was being treated for a systemic bacterial infection, however was unresponsive to empirical antibiotic therapy. To exclude an occult malignancy, an 18-fluorodeoxyglucose positron emission tomography scan was conducted. Significant bone marrow uptake was noted, prompting a bone marrow aspirate and trephine to investigate for a hematological malignancy. While the trephine biopsy was benign, a culture of the aspirate grew Candida parapsilosis . Intravenous antifungal therapy was initiated; however, the patient did not improve despite targeted therapy likely due to delays in diagnosis, and was palliated.
Conclusion: Our case seeks to demonstrate a novel case whereby a bone marrow aspirate culture provided a conclusive diagnosis of invasive Candida parapsilosis bone marrow infection, and guided treatment in an immunocompetent patient. It is important for clinicians to consider invasive fungal infections in febrile patients regardless of immune status. Additionally, when performing a bone marrow aspirate and trephine on a febrile patient, we recommend including aspirate fungal cultures to investigate for an invasive fungal infection.
Competing Interests: None.
(© 2024 The Authors.)
Case Report: An 83-year-old woman presenting with fevers and tachypnoea was being treated for a systemic bacterial infection, however was unresponsive to empirical antibiotic therapy. To exclude an occult malignancy, an 18-fluorodeoxyglucose positron emission tomography scan was conducted. Significant bone marrow uptake was noted, prompting a bone marrow aspirate and trephine to investigate for a hematological malignancy. While the trephine biopsy was benign, a culture of the aspirate grew Candida parapsilosis . Intravenous antifungal therapy was initiated; however, the patient did not improve despite targeted therapy likely due to delays in diagnosis, and was palliated.
Conclusion: Our case seeks to demonstrate a novel case whereby a bone marrow aspirate culture provided a conclusive diagnosis of invasive Candida parapsilosis bone marrow infection, and guided treatment in an immunocompetent patient. It is important for clinicians to consider invasive fungal infections in febrile patients regardless of immune status. Additionally, when performing a bone marrow aspirate and trephine on a febrile patient, we recommend including aspirate fungal cultures to investigate for an invasive fungal infection.
Competing Interests: None.
(© 2024 The Authors.)