CONCURRENT ISOLATION OF CANDIDA-KRUSEI AND CANDIDA-TROPICALIS FROM MULTIPLE BLOOD CULTURES IN A PATIENT WITH ACUTE-LEUKEMIA

Reports of the concurrent isolation of more than one non-albicans spec ies of Candida from blood cultures of immunocompromised patients with disseminated candidiasis are extremely infrequent. We report on the is olation of Candida krusei and Candida tropicalis from 17 blood culture s that were taken from a 67-year-old white man with a diagnosis of acu te biphenotypic leukemia during a 2-week period of hospitalization for induction chemotherapy. Despite receiving high-dose amphotericin B th roughout this period, the status of the patient worsened, and he exper ienced pancytopenia, hypernatremia, azotemia, and disseminated intrava scular coagulation, which led to his death. Candida krusei and C tropi calis were isolated concurrently from 10 of the 17 blood cultures, whi le C krusei was the single isolate in three cultures and C tropicalis was isolated alone in four cultures. Each species manifested markedly different colonial morphological features. This case report serves to emphasize to microbiologists that they must exercise extreme suspicion when non-albicans species of Candida are isolated singly or concurren tly from blood cultures in neutropenic patients, given the increasing clinical significance of these yeasts.