Abstract
This report describes a chronically ill child who presented with high fever and was diagnosed with catheter-related sepsis. Aureobasidium pullulans variety melanigenum, a dematiaceous fungus that rarely causes opportunistic infections, was recovered from multiple blood cultures. Antifungal susceptibilities were performed and the minimum inhibitory concentration (MIC) for fluconazole was 64 mg/l, suggestive of fluconazole resistance. The patient made a full recovery after removal of the catheter line and treatment with liposomal amphotericin B. This is the first case report of an elevated in vitro fluconazole MIC of an A. pullulans isolate and only the third case of successful treatment of A. pullulans fungemia.
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Acknowledgements
We would like to acknowledge the UCLA Clinical Microbiology Laboratory and Elizabeth Thompson of the Fungus Testing Laboratory for their technical services. B.L.W. was supported by grant PR054228 from the U.S. Army Medical Research and Materiel Command, Office of Congressionally Directed Medical Research Programs.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
This paper was first published online on Early Online on 1 June 2010.