Case Report

First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii

Table 1

Cases of C. fabianii infection.

Reference/yearAge InfectionRisk factorTreatmentClinical outcome

Dooley et al., 1990 [8]57 yHansenula fabianii prostatitisCLL, recurrent urethral self-manipulation10-, 14-, and 28-d courses with ketoconazole, followed by AMB, duration NR.Relapse off azole therapy. With AMB, the patient had lasting relief without recurrence of infection.

Valenza et al., 2006 [9]46 yCandida fabianii bloodstream, lungAntibacterial therapy, enterocolitisFLU for 15 d, followed by caspofungin daily for 7 d.Disseminated intravascular coagulation, ischemic bowel, and persistent shock. Death at ICU, day 68.

Bhally et al., 2006 [11]5 weeksPichia fabianii BSIPrematurity, antibacterial therapy, and enterocolitisAMB for 22 d. Vascular catheter removal on d 2.Resolution of infection without sequelae at long-term follow-up.

Hamal et al., 2008 [10]40 yPichia fabianii endocarditisCongenital combined aortic incompetence of the mitral valve, recent craniectomyFLU for 48 d, then VOR for 21 d, and then AMB for 35 d. Cardiac surgery after 28 d on AMB.Recurrent stroke prior to cardiac surgery. Following surgery and AMB, no further evidence of infection.

Grenouillet et al., 2010 [12]11 dPichia fabianii skin lesion, BSI, and empyemaPrematurity, antibacterial therapy, and premature rupture of membranesFLU (duration NR) and then AMB and FC for 10 d (until death).Gastrointestinal and tracheal hemorrhage. Oliguric renal failure. Death on 41 d of life.

Gabriel et al., 2012 [14]53 yLindnera fabianii BSIAntibacterial therapy, mesenteric ischemiaCAS for 19 d, followed by FLU for 91 d, and bowel resection. Discharge from hospital on d 110.

Yun et al., 2013 [15]47 yLindnera fabianii BSIAntibacterial therapy, transplantation, steroids, and neutropeniaAMB (dose NR) for 8 d, followed by CAS for 14 d.Multiorgan failure, shock, and death.

Wu et al., 2013 [13]3 weeksPichia fabianii BSI Low birth weight, broad spectrum antibioticsFLU for 18 d.Resolution of infection with discharge from hospital.

Mlinarić-Missoni et al., 2015 [16]3.5 y/FC. fabianii BSILeukemia, neutropenia, and antibacterial therapyFLU for 5 d and then AMB for 14 d.Clearance of fungemia after 3 d. Resolution of infection with discharge from hospital.

Mlinarić-Missoni et al., 2015 [16]2 months/MC. fabianii UTIHydronephrosis, surgery, and antibacterial therapyFLU for 27 d, urinary catheter removal.Clearance of culture after 11 d. Discharge from hospital.

Mlinarić-Missoni et al., 2015 [16]Neonate/FC. fabianii UTIGastroschisis, surgery, mechanical ventilation, parenteral nutrition, and antibacterial therapyFLU for 27 d, urinary catheter removal, and CVC removal.Clearance of culture after 5 d. Discharge from hospital.

Mlinarić-Missoni et al., 2015 [16]Neonate/MC. fabianii UTIHydronephrosis, surgery, parenteral nutrition, and antibacterial therapyFLU for 30 d and then CAS for 10 d.Clearance of culture after 10 d. Discharge from hospital.

Mlinarić-Missoni et al., 2015 [16]Neonate/FC. fabianii BSIIntestinal atresia, surgery, parenteral nutrition, and antibacterial therapyFLU for 15 days, CVC removal.Clearance of culture after 7 d. Discharge from hospital.

Mlinarić-Missoni et al., 2015 [16]Neonate/FC. fabianii BSIPulmonary cyst, 740 g weight, antibacterial therapy, mechanical ventilation, and parenteral nutritionFLU for 2 d and then CAS for 21 d.Clearance of culture after 7 d. Discharge from hospital.

AMB: amphotericin B, BSI: bloodstream infection, CAS: caspofungin, CLL: chronic lymphocytic leukemia, CVC: central venous catheter, d: days, FC: flucytosine, FLU: fluconazole, ICU: Intensive Care Unit, ITRA: itraconazole, MIC: minimum inhibitory concentration, NR: not reported, VOR, voriconazole, and UTI: urinary tract infection.