Candida lusitaniae: A cause of breakthrough fungemia in cancer patients

Candida lusitaniae is an infrequent cause of fungemia. We identified 12 cas es of C. lusitaniae fungemia that occurred at the University of Texas M. D. Anderson Cancer Center from 1988 to 1999. The mean age of patients was 48 years (range 20-70 years). Eight patients had hematologic malignancy or had received a bone marrow transplant, and 4 had a solid tumor. Most patients (75%) were neutropenic (<10(3)/mm(3)). Treatment with amphotericin B alone failed for 3 of 6 patients, irrespective of neutropenic status. Fluconazole was effective as a single agent in 3 patients with solid tumors. The combi nation of amphotericin B plus fluconazole was effective treatment for two-t hirds of patients with hematologic malignancy, despite persistence of neutr openia. The mortality rate associated with C. lusitaniae infection was 25%. C. lusitaniae presents as breakthrough fungemia in immunocompromised patie nts and is associated with failure of amphotericin B therapy. Fluconazole m ay be a useful agent in the treatment of this infection.