Ann Clin Microbiol 2024;27:31-37. Emergence of Vanrija humicola as a pathogen of urinary tract infections in Korea
Patient 1 | Patient 2 | Patient 3 | Patient 4 | |||
---|---|---|---|---|---|---|
Age/sex | 46/F | 49/M | 71/M | 86/M | ||
Underlying diseases | Cervical cancer, past breast cancer 1 year ago | Esophageal rupture with multiple repair surgery | Non-small cell lung cancer, diabetes mellitus | Unknown carcinoma on neck | ||
Urine cultures positive for Vanrija humicola | ||||||
Specimen dates (HD) | Sep 2023 (14) | Nov 2023 (100) | Feb 2021 (45) | May 2021 (28) | ||
Quantity (CFU/mL) | >10,000 | 3,000 | >100,000 | >100,000 | ||
Other culture | No growth from blood cultures | No growth from blood and sputum cultures | No growth from stool and sputum cultures | No growth from blood cultures | ||
Fever (℃) | 38.6 | 37.7 | No | 38.7 | ||
Urinary catheter use (days) | Yes (24) | No | Yes (45) | No | ||
Comorbid conditions | Ileostomy, Percutaneous nephrostomy | Mediastinitis | Herpes simplex virus meningoen-cephalitis | Toxic epidermal necrolysis | ||
Prior immunosuppressant use (days) | Pembrolizumab (12) | No | Osimertinib (4) | Prednisolone (25) | ||
Prior antimicrobial use (days) | Meropenem (7) | Voriconazole (4), Vancomycin (15), Meropenem/Ertapenem (15) | No | Meropenem (4), Vancomycin (4) | ||
Laboratory findings | ||||||
WBC (/μL), neutrophils% | 17,600, 89% | 6,300, 64.1% | 11,300, 84.1% | 900, 57.6% | ||
CRP (mg/dL) | 9.56 | 0.78 | 6.48 | 5.54 | ||
Creatinine (mg/dL) | 0.73 | 3 | 0.46 | 0.84 | ||
Serum β-D-glucan (pg/mL) | Not tested | Not tested | Not tested | 600.4 | ||
Urinalysis | ||||||
Hemoglobin | 4+ | – | 4+ | – | ||
Nitrite | – | – | – | – | ||
Leukocyte | 3+ | – | – | – | ||
Bacteria/yeast | Not tested | Not tested | Yeast, many | Not tested | ||
Antifungal therapy (days) | None | Voriconazole (29) | None | Caspofungin (3) | ||
Clinical outcome | Discharge | Discharge | Discharge | Expired |