this is the first – to the best of our knowledge- case of invasive C. kefyr urinary tract infection in a COVID-19 ICU patient.
the pyelonephritis was associated with caliectasis due to fungus ball formation which is a rare entity.
resolution of the infection was achieved only by prolonged intravenous antifungal therapy without surgical intervention which is ordinarily inevitable.
Candida kefyr (Kluyveromyces marxianus), an ascomycetous environmental yeast, occasionally isolated from dairy products, represents an uncommon but emerging pathogen in immunocompromised patients. Herein, we present a case of C. kefyr pyelonephritis in a 41-year-old, previously immunocompetent, patient who was hospitalized in an COVID-19 ICU. Pyelonephritis was associated with caliectasis and obstruction due to possible fungus ball formation. Predisposing factors included ICU stay, use of broad spectrum antibiotics and steroids, central venous catheterization, mechanical ventilation and urologic manipulation. Susceptibility testing revealed high MIC values to amphotericin B. Infection was effectively controlled by prolonged administration of fluconazole without further surgical intervention. COVID-19 complicated with invasive candidiasis is an increasingly observed clinical situation that warrants high suspicion index and careful evaluation of laboratory data.El texto completo de este artículo está disponible en PDF.
Keywords : Candida kefyr, Urinary tract infection, Pyelonephritis, Invasive candidiasis, COVID-19, ICU
Abbreviations : Intensive