Peritoneal dialysis (PD) catheter-related peritonitis from Aureobasidium pullulans caused by poor caregiver's hand hygiene

First human case of Eidernor doerrieniae colonization in a peritoneal dialysis catheter: A warning from silent contamination

This report documents the first human case of Eidernor doerrieniae colonization in a peritoneal dialysis catheter, identified through DNA sequencing after a 52-year-old man observed brownish particles within his catheter. Despite the absence of peritonitis symptoms, prompt catheter removal and antifungal therapy successfully resolved the infection. Fungal cultures revealed cerebriform (brain-like) colonies, confirmed as E. doerrieniae using multi-targeted molecular diagnostics. A wet contamination event three weeks earlier was identified as the likely source. This case underscores the importance of recognizing intraluminal particles as an indicator of fungal colonization and highlights the critical role of timely intervention and advanced diagnostics in preventing fungal peritonitis.

Fungemia due to Aureobasidium pullulans

Aureobasidium pullulans is a yeast-like dematiaceous fungus ubiquitous in nature. It is a rare cause of skin and soft tissue infection, peritonitis, and catheter-related fungemia in certain human hosts. We report a case of recurrent A. pullulans catheter-related fungemia that was successfully treated with caspofungin, posaconazole, and catheter removal.

Aureobasidium melanigenum catheter-related bloodstream infection: a case report

BACKGROUND

Aureobasidium melanigenum is a ubiquitous dematiaceous fungus that rarely causes invasive human infections. Here, we present a case of Aureobasidium melanigenum bloodstream infection in a 20-year-old man with long-term catheter use.

CASE PRESENTATION

A 20-year-old man receiving home care with severe disabilities due to cerebral palsy and short bowel syndrome, resulting in long-term central venous catheter use, was referred to our hospital with a fever. After the detection of yeast-like cells in blood cultures on day 3, antifungal therapy was initiated. Two identification tests performed at a clinical microbiological laboratory showed different identification results: Aureobasidium pullulans from matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and Cryptococcus albidus from a VITEK2 system. Therefore, we changed the antifungal drug to liposomal amphotericin B. The fungus was identified as A. melanigenum by DNA sequence-based analysis. The patient recovered with antifungal therapy and long-term catheter removal.

CONCLUSION

It is difficult to correctly identify A. melanigenum by routine microbiological testing. Clinicians must pay attention to the process of identification of yeast-like cells and retain A. melanigenum in cases of refractory fungal infection.