INVASION OF AUREOBASIDIUM PULLULANS IN KIDNEY AND EYES OF IMMUNOSUPPRESSED PATIENTS

P. Palaniappan, F. Amran, F. A. Rashid, Valerie Ting Siau Mei, A. M. Mustafa, L. Yee, H. Ghazali
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Abstract

There were series of proven cases revealing opportunistic fungal infections in the cornea, cutaneous, subcutaneous and renal transplant patients. Renal involvements of opportunistic mold in immunocompromised especially in renal transplant recipients have remained a significant problem and a major cause of death worldwide. However, extensive literature reviews revealed no case of invasion in urolithiasis and rarely reported in endophthalmitis. Here, we report the case series of two rare cases related to a dematiaceous fungus, Aureobasidium pullulans. Both had an atypical presentation. Possible modes of entry and dissemination were discussed. Invasive surgical procedures, frequent uses of antibiotics and steroid could possibly predispose to its invasion in immunocompromised patients. This organism was identified through molecular techniques since culture yielded no growth. There was a good outcome following surgical intervention in both cases.
免疫抑制患者肾、眼的普鲁兰金黄色小孢子虫侵袭
在角膜、皮肤、皮下及肾移植患者中均有机会性真菌感染的病例。机会霉菌在免疫功能低下者,特别是肾移植受者中,肾脏受累一直是一个重大问题,也是世界范围内死亡的主要原因。然而,广泛的文献回顾显示,没有尿石症侵袭的病例,很少报道眼内炎。在这里,我们报告了两个罕见的病例系列,涉及到一种真菌,普鲁兰小孢子菌。两者的表现都不典型。讨论了可能的进入和传播方式。侵入性外科手术、频繁使用抗生素和类固醇可能使免疫功能低下的患者易受其侵袭。这种生物是通过分子技术鉴定的,因为培养没有生长。手术治疗后两例均有良好的预后。
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