Coinfection of Toenail Onychomycosis Caused by Rhodotorula mucilaginosa and Candida glabrata in an Immunocompromised Adult: A Case Report and Literature Review
نویسندگان
1 Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Microbiology, Islamic Azad University, Tehran Branch, Tehran, Iran
3 Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6 Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
7 Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
doi
10.22037/nbm.v10i3.39170چکیده
Background: Rhodotorula mucilaginosa and Candida glabrata have emerged as potential pathogens,particularly in immunosuppressed hosts. This study aimed to present a case of coinfection of Candida glabrataand Rhodotorula mucilaginosa in a 35-year-old immunosuppressed female with onychomycosis on the first andsecond left toenails.Cases Report: Causative agents were identified according to morphology, microscopic studies, culture, andDNA molecular analysis. Candida glabrata demonstrated high minimum inhibitory concentrations against thetested antifungals except itraconazole. Moreover, Rhodotorula mucilaginosa had shown low minimuminhibitory concentrations against clotrimazole and ketoconazole at a dilution of 0.25 μg/ml. Itraconazole isadministered at 200 mg twice daily for one week for toenails and as pulse treatment (for one week a month) at5 mg/kg daily with topical clotrimazole.Conclusion: Clinical improvement was noted in the patient's clinical examination after ten months. Informationabout the increasing resistance to antifungal agents helps decide antifungal prophylaxis and select the empiricaltherapy for cancer patients.
