Candidemia caused by Candida haemulonii: a case report and literature review in neonates

Abstract

Candidemia poses a significant challenge for hospitalized neonates with an increase in morbidity and mortality. However, candidemia caused by Candida haemulonii in newborns is rare but fatal. We report such a case in China and performed a literature review. A neonate with a gestational age of 31+6 weeks and a birth weight of 1,420g was diagnosed with C. haemulonii candidemia. The infectious agent was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and sequencing of the internal transcribed spacer region. The in vitro antifungal susceptibility testing indicated high minimal inhibitory concentrations for fluconazole (>128 µg/mL), voriconazole (>8 μg/mL), and amphotericin B (>4 µg/mL). Fortunately, the newborn was successfully treated with fluconazole. After a literature review of C. haemulonii candidemia, we found that the risk factors of the candidemia might involve premature, low birth weight, invasive therapeutic devices, broad-spectrum antimicrobial agents, and parenteral nutrition infusion. This study will broaden our knowledge on neonatal candidemia caused by C. haemulonii.