Open AccessCase report and literature review: double jeopardy – Exophiala dermatitidis and Mycobacterium canariasense central line-associated bloodstream infection in a patient
Author(s) -
Afrinash Ahamad,
Bushra Tehreem,
Maaz Farooqi,
Bennadette Maramara
Publication year - 2022
Publication title -
access microbiology
Language(s) - English
Resource type - Journals
ISSN - 2516-8290
DOI - 10.1099/acmi.0.000347
Subject(s) - voriconazole , medicine , fungemia , blood culture , intensive care medicine , moxifloxacin , bloodstream infection , catheter , clostridium difficile , microbiology and biotechnology , biology , immunology , antibiotics , surgery , mycosis , antifungal , dermatology
Central line-associated bloodstream infection (CLABSI) is the most common nosocomial-acquired infection, affecting 38 000 patients in the USA annually. Approximately 8–10 % of inserted catheters lead to bloodstream infections, and ~25–30 % of infections are associated with mortality. Although proper line maintenance is essential to prevent infection, it is quite a challenge to avoid infection in patients with a long-term catheter. We present a case of a female in her 40s with a previous history of irritable bowel syndrome (IBS) who has had a central line for total parenteral nutrition for the past 2 years. The patient recently visited the emergency room with fever and generalized fatigue. Blood cultures sent to microbiology were positive for black mould, Exophiala dermatitidis . However, after a few days, microbiology reported an additional micro-organism, Mycobacterium canariasense , a pathogen rarely associated with bacteraemia. The patient was administered voriconazole and moxifloxacin for black mould and mycobacterium infection, respectively. We present an unusual case of rare opportunistic organisms causing bacteraemia and fungaemia in a patient with a long-term catheter. CLABSI remains a serious challenge for clinical facilities. Implementation and monitoring of effective strategies can prevent catheter-related bloodstream infections in patients with long-term catheters and can reduce the morbidity and mortality associated with CLABSI.