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Dear Editor, Lodderomyces elongisporus was first described as a cause of bloodstream infections in 2008 [1]. We present a case of L. elongisporus fungemia in a patient with lung cancer who had a central venous catheter. A 56-year-old female presented at the emergency department of Asan Medical Center (Seoul, Korea) complaining of dyspnea. She had undergone a left lung lobectomy because of non-small cell lung cancer and had been treated with high-dose dexamethasone and cord decompression surgery for spinal cord metastasis two months ago; she was then treated with meropenem and teicoplanin for one week, owing to methicillin-resistant Staphylococcus aureus bacteremia. She was subsequently transferred to a secondary care hospital, in which a peripherally inserted central catheter had been placed for chemotherapy with docetaxel and antimicrobials. This study was performed retrospectively and was exempt from the requirements of informed consent and ethical approval. Initial vital signs revealed a spiking fever up to 40°C. Abnormal laboratory findings included a peripheral leukocyte count of 19.9×10/L, platelets at 69×10/L, C-reactive protein at 1,937.2 nmol/L, lactate dehydrogenase at 6.13 μkat/L, prothrombin time of 14.2 seconds, activated partial thromboplastin time of 42.8 seconds, and D-dimer at 72.3 nmol/L. Chest computed tomography showed pleural effusion with multiple lung nodules and an edematous gall bladder. Three sets of Bactec blood culture (Beckton-Dickenson, Sparks, MD, USA) collected at admission grew a single morphotype of yeast in aerobic vials only. Detection times were 25.7 hours for catheter-drawn blood and 28.6 and 31.1 hours in two peripheral blood sets. Microscopic evaluation of this yeast showed blastoconidia and branching pseudohyphae similar to those in Candida parapsilosis (Fig. 1). CHROMagar Candida medium (Komed, Sungnam, Korea) revealed a turquoise-blue colony, which differed from the green colonies of Candida albicans and blue colonies of Candida tropicalis (Fig. 1). The Vitek 2 YST ID (bioMérieux, Durham, NC) and API 20C AUX (bioMérieux) system identified it as C. parapsilosis. However, Bruker Biotyper MALDI-TOF (Brucker Daltonics, Breman, Germany) analysis indicated a likely identification of L. elongisporus (score value=1.79), followed by C. parapsilosis (score value=1.12). Sequence analysis of an internal transcribed spacer (ITS) region of ribosomal DNA demonstrated 100% homology with L. elongisporus and 97% homology with C. parapsilosis. By antifungal susceptibility testing using ATB Fungus 3 (bio-

Catheter-related Bloodstream Infection due to Lodderomyces elongisporus in a Patient with Lung Cancer