Lab Med Online.  2016 Apr;6(2):102-105. 10.3343/lmo.2016.6.2.102.

Sepsis Due to Rhodotorula mucilaginosa in a Patient with Advanced Non-Small Cell Lung Cancer

• Bae TW
• Lee J
• Cho YG
• Kim DS
• Choi SI
• Lee HS

• KMID: 2160092
• DOI: http://doi.org/10.3343/lmo.2016.6.2.102

Abstract

Rhodotorula species are round to oval-shaped, multilateral budding, encapsulated yeasts that produce urease and do not ferment carbohydrates. Rhodotorula species form characteristic salmon-pink colored colonies owing to carotenoid pigment production. These yeasts form a part of the normal flora of moist skin and are found in the environment. Rhodotorula was traditionally considered a contaminant but is now progressively recognized as a human pathogen, especially in immunocompromised patients with central venous catheters. However, isolation of Rhodotorula species from blood has been very rarely reported in Korea. We report a case of sepsis due to Rhodotorula mucilaginosa infection in a patient who had received chemotherapy and supportive care for non-small cell lung cancer.

Keyword

Sepsis; Rhodotorula mucilaginosa; Fungemia

MeSH Terms

Carbohydrates
Carcinoma, Non-Small-Cell Lung*
Central Venous Catheters
Drug Therapy
Fungemia
Humans
Immunocompromised Host
Korea
Rhodotorula*
Sepsis*
Skin
Urease
Yeasts
Carbohydrates
Urease

Figure

• 

  Fig. 1 Rhodotorula mucilaginosa on Sabouraud's dextrose agar (30℃, 5 days).

• 

  Fig. 2 Gram stain of Rhodotorula mucilaginosa (magnification: ×1,000).

Reference

1. El-Tahawy AT, Khalaf RM. Rhodotorula rubra fungemia in an immunocompromised patient. Ann Saudi Med. 1999; 19:533–535.

2. Chung JW, Kim BN, Kim YS. Central venous catheter-related Rhodotorula rubra fungemia. J Infect Chemother. 2002; 8:109–110.

3. Kim HA, Hyun M, Ryu SY. Catheter-associated Rhodotorula mucilaginosa fungemia in an immunocompetent host. Infect Chemother. 2013; 45:339–342.

4. Miceli MH, Diaz JA, Lee SA. Emerging opportunistic yeast infections. Lancet Infect Dis. 2011; 11:142–151.

5. Louria DB, Greenberg SM, Molander DW. Fungemia caused by certain nonpathogenic strains of the family Cryptococcaceae. Report of two cases due to Rhodotorula and Torulopsis glabrata. N Engl J Med. 1960; 263:1281–1284.

6. De Almeida GM, Costa SF, Melhem M, Motta AL, Szeszs MW, Miyashita F, et al. Rhodotorula spp. isolated from blood cultures: clinical and microbiological aspects. Med Mycol. 2008; 46:547–556.

7. Lunardi LW, Aquino VR, Zimerman RA, Goldani LZ. Epidemiology and outcome of Rhodotorula fungemia in a tertiary care hospital. Clin Infect Dis. 2006; 43:e60–e63.

8. Wirth F, Goldani LZ. Epidemiology of Rhodotorula: an emerging pathogen. Interdiscip Perspect Infect Dis. 2012; 2012:465717.

9. Diekema DJ, Petroelje B, Messer SA, Hollis RJ, Pfaller MA. Activities of available and investigational antifungal agents against Rhodotorula species. J Clin Microbiol. 2005; 43:476–478.

10. Zaas AK, Boyce M, Schell W, Lodge BA, Miller JL, Perfect JR. Risk of fungemia due to Rhodotorula and antifungal susceptibility testing of Rhodotorula isolates. J Clin Microbiol. 2003; 41:5233–5235.

11. Feldmesser M, Kress Y, Mednick A, Casadevall A. The effect of the echinocandin analogue caspofungin on cell wall glucan synthesis by Cryptococcus neoformans. J Infect Dis. 2000; 182:1791–1795.

12. Tuon FF, Costa SF. Rhodotorula infection. A systematic review of 128 cases from literature. Rev Iberoam Micol. 2008; 25:135–140.

13. Hsueh PR, Teng LJ, Ho SW, Luh KT. Catheter-related sepsis due to Rhodotorula glutinis. J Clin Microbiol. 2003; 41:857–859.

14. Sood S, Nerurkar V. Rhodotorula glutinis fungaemia. Indian Journal of Medical Specialities. 2013; 4:112–114.