EP574 - CANDIDA GUILLIERMONDII IN A PATIENT WITH WILMS TUMOR AFTER TREATMENT WITH DEXAMETHASONE DUE TO CANCER HEMOPHAGOCYTOSIS (ID 1482)
Abstract
Title of Case:
CANDIDA GUILLIERMONDII IN A PATIENT WITH WILMS TUMOR AFTER TREATMENT WITH
DEXAMETHASONE DUE TO CANCER HEMOPHAGOCYTOSIS
Background:
To describe a non-Candida albicans fungemia in a cancer patient treated for
Hemophagocytic lymphohistiocytosis (HLH). Candida Guilliermondii is part of the normal
fungal microbiota of human skin and mucosa. It is a rare cause of invasive candidiasis in
cancer patients, particularly those with hematological malignancies. There is limited
literature and only few cases have been reported worldwide, especially in pediatric
population.
Case Presentation Summary:
A two-year-old female patient with Wilms Tumor was hospitalized
with fever (38 o C) after 6 weeks of successful treatment of HLH with dexamethasone.
Laboratory tests results included leukocytosis 15,6 K/μL (3,8 – 10,5 Κ/μL) with 82%
neutrophils, 11,8% lymphocytes, normal rates of hemoglobin concentration and platelet
count and substantially elevated C-reactive protein level (59,4mg/L, normal rate <6mg/L).
C. Guilliermondii was isolated from the central vein catheter (CVC) blood culture. CVC was replaced and intravenous (IV) antifungals therapy (micafungin 2mg/kg per day) was administrated for ten days. She became afebrile the next day, whereas blood
culture from CVC was negative on third day of treatment. The child was stable and afebrile
during the whole hospitalization.
Learning Points/Discussion:
Recognizing non-albicans Candida species as clinically relevant pathogens is
important due to its decreased susceptibility to antifungal agents. C. guilliermondii poses a
threat in the hospital setting, particularly in cancer patients,
immunocompromised and patient with indwelling CVC.
