Disease relevance of Fungemia

• In spite of the continued administration of amphotericin, with the addition of 5-fluorocytosine, Trichosporon was later cultured from her blood, and she succumbed to fungemia and polymicrobial sepsis [1].
• Failure of fluconazole to suppress fungemia in a patient with fever, neutropenia, and typhlitis [2].
• OBJECTIVE: To determine the minimum volume of blood and the absolute number of organisms required for detection of bacteremia and fungemia by an automated colorimetric blood culture system (BacT/Alert, Organon Teknika) [3].
• Fungal peritonitis and Paecilomyces fungemia ensued, which were treated with amphotericin B and catheter removal [4].
• We conclude that fungemia in HIV-infected children often presents as a community-acquired infection, is frequently due to newly emerging opportunistic fungi, and can be managed, with a high level of success (95% survival with no posttherapeutic sequelae), by early diagnosis, prompt initiation of amphotericin B therapy, and removal of the CVC [5].

High impact information on Fungemia

• Fluconazole and Candida krusei fungemia [6].
• Two adults are described in whom Malassezia furfur fungemia developed while receiving total parenteral nutrition supplemented with lipids [7].
• Thirty-seven percent of the patients with C. albicans fungemia were receiving oral prophylactic nystatin therapy [8].
• A panfungal PCR assay was used to evaluate the ability of the ESP blood culture system to detect fungemia [9].
• Outbreak of Saccharomyces cerevisiae subtype boulardii fungemia in patients neighboring those treated with a probiotic preparation of the organism [10].

Chemical compound and disease context of Fungemia

• The fungemia responded to therapy with amphotericin B, but the patient died of multisystem failure [11].
• Seventy-seven percent of the C. parapsilosis fungemias were related to total parenteral nutrition [8].
• Candida glabrata fungemia in transplant patients receiving voriconazole after fluconazole [12].
• Controlled evaluation of hypertonic sucrose medium for detection of bacteremia and fungemia in supplemented peptone broth [13].
• These data suggest that the capacity of Candida species isolates to produce biofilms in vitro in glucose-containing SDB may be a reflection of the pathogenic potential of these isolates to cause CVC-related fungemia in patients receiving TPN [14].

Biological context of Fungemia

• Candida parapsilosis fungemia associated with parenteral nutrition and contaminated blood pressure transducers [15].
• Biofilm production has been implicated as a potential virulence factor of some Candida species responsible for catheter-related fungemia in patients receiving parenteral nutrition [14].
• Rhodotorula spp. fungemia in an immunocompromised boy after neurosurgery successfully treated with miconazole and 5-flucytosine: case report and review of the literature [16].

Anatomical context of Fungemia

• RESULTS: Patients with central nervous system infection (69% vs. 16%, P = 0.00001), disseminated infection (82.7% vs. 20%, P = 0.00001), and fungemia (29% vs. 8%, P = 0.046) were more likely to receive regimens containing amphotericin B than fluconazole as primary therapy [17].
• Nosocomial Cryptococcus laurentii fungemia in a bone marrow transplant patient after prophylaxis with ketoconazole successfully treated with oral fluconazole [18].
• Two granulocytopenic patients in whom fungemia persisted despite therapy with deoxycholate amphotericin B were subsequently successfully treated by daily intravenous administration of amphotericin B entrapped in sonicated liposomes made of egg yolk lecithin, cholesterol and stearylamine in a molar ratio of 4:3:1 [19].

Gene context of Fungemia

• The BACTEC high-blood-volume fungal medium (HBV-FM) (Becton Dickinson Diagnostic Instrument Systems, Sparks, Md.) was compared with the Isolator (IS) tube and the BACTEC Plus 26 (BP26) blood culture bottle for the ability to recover fungi from the blood of adult patients suspected of having fungemia [20].
• Although shock developed soon after fungemia with the C. albicans clinical isolate, TNF-alpha concentrations did not increase above normal saline values in either candidemic group at t = 1.5, 4.5, or 6 hrs (17 +/- 7 vs. 14 +/- 1 U/mL in the parent C. albicans organism vs. its agerminative mutant at t = 6 hrs) [21].
• Murine studies have reported elevated serum macrophage colony-stimulating factor (M-CSF) concentrations in animals inoculated with fungus; however, the human cytokine response to fungemia has not been described [22].
• Controlled comparative evaluation of BacT/Alert FAN and ESP 80A aerobic media as means for detecting bacteremia and fungemia [23].
• Candida krusei fungemia in an unrelated allogeneic hematopoietic stem cell transplant patient successfully treated with Caspofungin [24].

Analytical, diagnostic and therapeutic context of Fungemia

• We performed antifungal susceptibility tests with cilofungin (LY121019), amphotericin B, and flucytosine against 38 strains of yeasts from patients with esophagitis or fungemia either before, during, or after treatment with cilofungin [25].
• Univariate analysis pointed to the following significant risk factors: blood alkalosis, reduced urea, duration of hospitalization, bacteremia and colonization with Pseudomonas aeruginosa, and an APACHE II score >17 (during bacteremia or fungemia) [26].

References