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- Title
CANDIDA KEFYR (KLUVYEROMYCES MARXIANUS) AS A NOTABLE YEAST IN PATIENTS RECEIVING TREATMENT FOR CHILDHOOD CANCER.
- Authors
Yılmaz, Ebru; Erdoğmuş, Necdet Arda; Özcan, Alper; Uçan, Gülşah; Atalay, Altay; Karakükçü, Musa; Patıroğlu, Türkan; Ünal, Ekrem
- Abstract
Introduction: Candida species found in normal human flora can cause infection in immunocompromised patties. Although Candida infections are frequently observed with Candida albicans strains, the incidence of infections with non-albicans strains has increased recently. Candida kefyr, one of these, is a rare fungal pathogen. We aimed to present our experience in five patients with Candida kefyr infection between 2010-2018. Case report: C. kefyr grew from the blood culture in a 2-years-old girl with mediastinal T-cell lymphoblastic lymphoma when the absolute neutrophil count was 1070/mm3, and the patient was receiving oral voriconazole and iv amphotericin B. These two antifungal drugs were then switched to fluconazole. C. kefyr was re-established in blood culture 45 days after the first grew so fluconazole treatment continued because it was sensitive. A 2-years-old girl with pulmonary primitive neuroectodermal tumor was hospitalized for febrile neutropenia. Although antibiotic, fluconazole, and granulocyte colony stimulating factor treatment was used, C. kefyr grew in the blood cultures. Amphotericin b that found to be sensitive was switched. There was no reproduction in the control blood culture. One-year-old boy with infantile leukemia with a history of hematopoietic stem cell transplantation was admitted with diarrhea and hospitalized with a differential diagnosis of gastrointestinal graft versus host disease. Fluconazole therapy which was sensitive to the isolated strain was given to the patient. There was no reproduction in the follow up. A 17-year-old male patient with medullary and central nervous system relapse was hospitalized for hematopoietic stem cell transplantation. Lumber punction was performed because the patient has h high fever and headache. He was neutropenic, and C. keyfr was grew from the cerebro spinal fluid Amphothericin B was replaced with caspofungin which was found to be effective to the isolated C. kefyr. He was discharged with oral voriconazole therapy. A 9-year-olds girl with B-cell Acute lymphoblastic leukemia was hospitalized for neutropenic fever, and shortness of breath, cough, and mucositis. The C. kefyr grew from sputum, so fluconazole treatment was given for 21 days. Her respiratory symptoms were resolved with this treatment. Conclusion: C. keyfr is one of the most frequently isolated non albicans candida fungal pathogens in our treated patients. C. kefyr should be considered to as a relatively common and potentially causative non C. albicans agent in children with hematological malignancy and bone marrow transplantation.
- Subjects
CANDIDIASIS; CANCER treatment; BONE marrow transplantation; CHILDHOOD cancer; CANDIDA albicans; YEAST fungi
- Publication
Erciyes Medical Journal / Erciyes Tip Dergisi, 2018, Vol 40, Issue 1, pS1
- ISSN
2149-2247
- Publication type
Case Study