kjcm Korean Journal of Clinical Microbiology Korean J Clin Microbiol 1229-0025 Korean Journal of Clinical Microbiology 10.5145/KJCM.2010.13.3.140 kjcm-13-140 Original Article A Fatal Case of Candida orthopsilosis Fungemia Choi Hyun Jung 1 Shin Jong Hee 1 Park Kyung Hwa 2 Shin Myung Geun 1 Suh Soon Pal 1 Ryang Dong Wook 1 Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea Correspondence: Jong Hee Shin, Department of Laboratory Medicine, Chonnam National University Medical School, 671 Jebong-ro, Dong-gu, Gwangju 501-757, Korea. (Tel) 82-62-220-5342, (Fax) 82-62-224-2518, (E-mail) shinjh@chonnam.ac.kr 92010 2192010 133 140143 10052010 23072010 20082010 Copyright © 2010 Korean Journal of Clinical Microbiology 2010 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract

Candida orthopsilosis is a recently described Candida species phenotypically indistinguishable from Candida parapsilosis. This new species can be identified only by using molecular methods. We describe here a fatal case of fungemia caused by C. orthopsilosis in a 75-year-old male patient who had panperitonitis after total gastrectomy with Roux-en-Y esophagojejunostomy. All 18 blood cultures obtained from admission day 16 to day 68 yielded the same Candida species. Both Vitek 2 (bioMerieux, Inc., Hazelwood, MO, USA) and API 20C (bioMerieux, Marcy-l'Etoile, France) failed to identify these isolates. However, DNA sequencing analysis of both D1/D2 domain and internal transcribed spacer region of rDNA showed 100% identity with C. orthopsilosis. The fungemia was persistent over 50 days despite of systemic antifungal therapy including fluconazole and caspofungin, and the patient expired on day 73 of his hospital stay. This represents the first reported case of fatal fungemia by C. orthopsilosis in Korea.

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