CATHETER-RELATED MALASSEZIA-FURFUR FUNGEMIA IN IMMUNOCOMPROMISED PATIENTS

PURPOSE, PATIENTS, AND METhODS: Malassezia furfur has usually been des cribed as a cause of catheter-related sepsis in neonates receiving int ravenous lipid emulsion. We report seven cases of catheter-related M. furfur fungemia that occurred in seven immunocompromised patients incl uding four adults and three children who were not neonates. Only two o f these patients were receiving concurrent intravenous lipid emulsion. RESULTS. All positive blood cultures were obtained from a central ven ous access device, one of which was a port device. Quantitative M. fur fur colony counts ranged from 50 cfu/mL to greater than 1,000 cfu/mL. All seven patients were treated with amphotericin B. Blood drawn throu gh the central lines of three patients yielded additional organisms. O ne central venous access device required removal due to persistently p ositive M. furfur blood cultures despite treatment with amphotericin B . CONCLUSION: We conclude that catheter-related M. furfur fungemia occ urs in immunocompromised patients with central venous access devices w hether or not they are receiving intravenous lipids. Prompt, aggressiv e treatment with amphotericin B (1 mg/kg/d) may spare patients removal of their central venous access device. Further studies are needed to determine the role of endogenous lipids in the development of catheter -related M. furfur fungemia and to determine ff there is a seasonal in cidence in populations other than neonates, since all of our cases occ urred between late March and July.