GENETIC DISSIMILARITY OF 2 FLUCONAZOLE-RESISTANT CANDIDA-ALBICANS STRAINS CAUSING MENINGITIS AND ORAL CANDIDIASIS IN THE SAME AIDS PATIENT

We describe a patient with AIDS who simultaneously developed Candida m eningitis with three positive cerebrospinal fluid cultures and oral ca ndidiasis. This patient also had a history of recurrent episodes of or al candidiasis treated with fluconazole. The patient did not respond t o this therapy but was cured with amphotericin B and flucytosine. In v itro susceptibility tests revealed that each infection was caused by f luconazole-resistant Candida albicans isolates. Strain delineation by karyotyping, NotI restriction pattern analysis, hybridization with the specific probe 27A, and PCR fingerprinting with the phage M13 core se quence clearly demonstrated that meningitis and oral thrush were cause d by two genetically different isolates.