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Figure 1. Response of Candida kefyr bloodstream infection in patient 3 to combination antifungal therapy that included caspofungin. Staphylococcus epidermidis was also detected in 2 blood cultures but disappeared after antibiotic treatment, according to the antibiogram. Day 0 was the day of allogeneic peripheral blood stem cell transplantation (PBSCT). a, Graph depicting recovery of the leukocyte and the granulocyte counts. b, Serum levels of C-reactive protein (CRP). +, Blood cultures positive for C. kefyr. *Blood cultures positive for S. epidermidis. c, Graph showing the highest daily body temperature. d, Schematic representation of the antifungal therapy given after PBSCT. Dosages were as follows: nystatin, 1.5 million IU/day orally; caspofungin, 50 mg/day intravenously; fluconazole, 600 mg/day intravenously; amphotericin B, 3 mg/kg/day intravenously. 12. Kontoyiannis DP, Lionakis MS, Lewis RE, et al. Zygomycosis in a tertiary-care cancer center in the era of Aspergillus active antifungal therapy: a case control observational study of 27 recent cases. J Infect Dis 2005; 191:1350–60.

Candida kefyr as an Emerging Pathogen Causing Nosocomial Bloodstream Infections in Neutropenic Leukemia Patients