Disseminated infection due to Candida guilliermondii in a patient with AML(M4). Case study.

UNLABELLED: A 43-year-old patient admitted with acute myelogenous leukemia, developed bronchopneumonia and sepsis during profound neutropenia. Fever and pulmonary infiltrates did not improve by using empiric antibacterial therapy (Cefoperazona-Sulbactam, Trimethoprim-Sulphametoxazol). Blood and sputum culture were performed and patient received Voriconazol. Both cultures, from blood and sputum, yielded Candida guilliermondii after 48 hours of incubations. The isolates have the same biochemical and antimicrobial spectrum and were susceptible to Amphotericin B and Fluconazole. After a few days of therapy with Voriconazol, fever disappeared and the clinical state of patient was improved. A culture from pharyngeal swab, performed after 11 days, yielded the same microorganism.

CONCLUSIONS: (1) The emergence of less common, but medically important fungal pathogens, including Candida guilliermondii, contributes to the rate of morbidity and mortality, especially in the increasingly expanding population of immunocompromised patients. (2) We consider that the oropharyngeal colonization with Candida guilliermondii and profound neutropenia predispose our patient to develop bronchopneumonia and candidemia.