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Journal of Clinical Microbiology, February 2001, p. 514-518, Vol. 39, No. 2
Mycology Laboratory, Hospital
Universitário Clementino Fraga Filho, Universidade Federal do Rio
de Janeiro, Brazil,1 and Departments of
Medicine2 and
Pathology,3 The University of Texas
Health Science Center at San Antonio, and Audie L. Murphy
Division, South Texas Veterans Health Care
System,4 San Antonio, Texas
Received 25 August 2000/Returned for modification 10 October
2000/Accepted 16 November 2000
Fungi have become increasingly important causes of nosocomial
bloodstream infections. The major cause of nosocomial fungemia has been
Candida spp, but increasingly molds and other yeasts have
caused disease. Exophiala jeanselmei and
members of the genus Rhinocladiella are dematiaceous
moulds, which have been infrequently associated with systemic infection
and have not been described as causes of fungemia. In this paper, the
occurrence of 23 cases of fungemia due to these organisms over a
10-month period is reported and the clinical characteristics of
patients and outcomes are described. The majority of patients were
immunosuppressed; 21 of 23 (91%) had received blood products and 78%
had a central venous catheter. All patients had at least one
manifestation of fever, but only one patient had signs or symptoms
suggesting deep-seated infection. Antifungal therapy was given to 19 of
the 23 patients; of those who did not receive therapy, 3 died prior to
the culture result and 1 had been discharged without therapy.
Antifungal susceptibility of the organisms showed activity of
amphotericin B, itraconazole, and the new triazole antifungals
voriconazole and posaconazole. E. jeanselmei and Rhinocladiella species are
potential causes of nosocomial fungemia and may be associated
with systemic infection.
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.2.514-518.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Nosocomial Fungemia Due to Exophiala jeanselmei var.
jeanselmei and a Rhinocladiella Species: Newly
Described Causes of Bloodstream Infection
*
Corresponding author. Mailing address: Hospital
Universitário Clementino Fraga Filho, Universidade Federal do Rio
de Janeiro, Av. Brigadeiro Trompovsky s/n 21941-590, Rio de Janeiro,
Brazil. Phone and Fax: 5521-5622460. E-mail:
mnucci{at}hucff.ufrj.br.
Present address: The University of Texas Southwestern Medical
School, Dallas, Tex.
Journal of Clinical Microbiology, February 2001, p. 514-518, Vol. 39, No. 2
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.2.514-518.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
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