Hansenula anomala Fungemia in a Patient with Acute Myelocytic Leukemia

Abstract

A case of fungemia due to Hansenula anomala is reported. The infection developed in a 35-year-old woman with acute myelocytic leukemia who was receiving immunosuppression therapy and intravenous hyperalimentation (IVH). From cultures of both peripheral blood specimens and IVH-catheter tips taken during a febrile episode, a species of yeast was isolated repeatedly as the sole organism. After treatment with intravenous fluconazole (400mg/day), the fever was reduced and the blood became culture-negative. The patient later died of disseminated intravascular coagulation (DIC) associated with underlying disease. The morphology and biochemical characteristics of the isolate were compatible with the features of Candida pelliculosa (perfect state: H. anomala). The isolate was identified by the shape of ascospores produced which is peculiar to H. anomala. Susceptibility of the isolate to currently available antifungal agents was as follows (MIC): amphotericin B, 1.25μg/ml; flucytosine, <0.04μg/ml; miconazole, 1.25μg/ml; itraconazole, 5.00μg/ml and fluconazole, 1.25μg/ml. Human infections due to H. anomala are rare and this is only the third case in Japan. From now on this organism should be recognized as one of the pathogens of opportunistic infections in patients undergoing IVH-treatment.