Reinaldo Ramirez
University of Puerto Rico, USA
Title: Kodamaeda ohmeri: an unusual case of fungemia and endocarditis successfully treated with fluconazole
Biography
Biography: Reinaldo Ramirez
Abstract
Kodamaea ohmeri has only been identified as the causative agent of infections in humans in a scarce amount of cases.
A 43 year old male patient who was sent to the Emergency Room after routine laboratories showed leukocitosis and a blood culture grew up yeast. Patient recently finished a course of 42 days of intravenous empiric antibiotic therapy with Vancomycin and Zosyn for a left foot osteomyelitis via a peripheral inserted central catheter. Upon evaluation, vital signs were stable and there was a right arm peripheral inserted central line catheter in place, without nearby erythema, induration or suppuration. Laboratory tests revealed leukocitosis. Patient was empirically administered caspofungin. A yeast-like organism was isolated from the patient’s blood and from the tip of the catheter, which was later identified as K. ohmeri. Transthoracic echocardiogram revealed a mobile echodense structure associated to the aortic and tricuspid valve, suggestive of vegetation. On follow up blood cultures the same yeast was isolated from her blood. Therapy was changed to Fluconazole. Transesophageal echocardiogram was then performed and was negative for vegetations. Subsequent blood cultures were also negative. Upon completion of therapy, patient was discharged home in a stable condition.
This case illustrates a rare cause of fungal endocarditis and fungemia, which was successfully treated with with fluconazole. K. ohmeri is an uncommon human pathogen, with only a few case reports in the medical literature. Due to its rareness, data regarding optimal treatment regimens is limited. Further studies are needed to establish the optimal antifungal regimens.