Rhodotorula Fungemia of an Intensive Care Unit Patient and Review of Published Cases

Rhodotorula species are commensal yeasts that have emerged as a cause of life-threatening fungemia in severely immunocompromised patients. A case of Rhodotorula mucilaginosa fungemia in a 48-year-old woman that had undergone consecutive abdominal surgeries due to ovarian cancer and bowel necrosis while she was receiving fluconazole prophylaxis is presented. Several risk factors were identified such as presence of central venous catheters, solid organ neoplasm, abdominal surgery and administration of antibiotics. Identification was performed using commercial systems. The yeast was resistant to fluconazole, posaconazole and voriconazole and to echinocandins, whereas MIC to amphotericin B was 1.5 mg/L. Furthermore, published cases of Rhodotorula spp fungemia during the last decade are reviewed. In conclusion, Rhodotorula spp must be considered a potential pathogen in patients with immunosupression and central venous catheters. Correct identification is mandatory for appropriate management, as Rhodotorula spp are resistant to antifungal agents, such as fluconazole and echinocandins.