The spectrum of Malassezia infections in the bone marrow transplant population

A consecutive series of 3044 patients who underwent BMT at the University o f Minnesota over a 25 year period were reviewed for the post-transplant occ urrence of infection caused by the yeast Malassezia furfur. Six patients, r anging in age from 1 to 54 years, developed Malassezia infections at a medi an of 59 days post transplant. Five patients were allogeneic transplant rec ipients; the remaining patient had undergone autologous transplantation. A spectrum of clinical manifestations of Malassezia infection was seen in the se patients, including infections of mucosal surfaces and the skin, in addi tion to catheter-related fungemia, Unlike many of the other more common opp ortunistic fungal infections in inmunocompromised patients, neutropenia and the use of broad-spectrum antimicrobials do not appear to be significant r isk factors for Malassezia infections in the BMT population, In addition, d isseminated fungal infection despite the presence of fungemia is uncommon. Lastly, the outcome of Malassezia infections in these patients, whether fol liculitis, mucosal infection, or fungemia, appears to be quite favorable, i n contrast to the poorer outcome with many other fungal infections in BMT p atients. Catheter removal and discontinuation of intravenous lipids are imp ortant for a successful outcome in fungemic cases.