Candida lusitaniae: An important emerging cause of candidemia

Candida lusitaniae is a rare cause of candidemia, with only 15 cases previously reported in the medical literature. We describe five additional cases of C. lusitaniae fungemia and one case of culture- and histopathology-proven C. lusitaniae skin infection. We also review the other 15 cases reported in the literature. Microbiologicpersistence appears to be the hallmark of C. lusitaniae infection, with 33% of our patients and 67% of those previously reported demonstrating persistent infection with amphotericin B (AmB) therapy. Despite the common belief that C. lusitaniae is resistant to AmB, we found all of our isolates were susceptible in vitro to AmB except for one isolate from a patient who had received prior AmB therapy. Moreover, four of our six patients were successfully treated with AmB. We describe two cases of C. lusitaniae breakthrough fungemia occurring during fluconazole therapy, AmB appears to be the drug of choice for patients with C. lusitaniae fungemia, although we documented one case of successful therapy with fluconazole. All patients should be closely monitored during therapy for the possible emergence of antifungal resistance.