J Biomed Transl Res.  2016 Jun;17(2):036-039. 10.12729/jbtr.2016.17.2.036.

Kodamaea ohmeri Fungemia in a Patient with Carcinoma of the Ampulla of Vater

• Son BR
• Shin KS

• KMID: 2368704
• DOI: http://doi.org/10.12729/jbtr.2016.17.2.036

Abstract

Kodamaea ohmeri, previously known as Pichia ohmeri or Yamadazyma ohmeri, is an ascosporogenous yeast that belong to the Saccharomycetaceae family, and it is a rare yeast-form fungus recently identified as an etiological agent of fungemia, endocarditis, urinary tract infection and peritonitis in immunocompromised patients. This paper presents a case of K. ohmeri fungemia in a 70-year-old man with carcinoma of the ampulla of Vater. After receiving endoscopic retrograde cholangiopancreatography (ERCP) for releasing obstruction of ampulla of Vater by insertion of the biliary stent, he was pyrexial with a temperature of 38.5℃. Two set of blood samples were obtained from a peripheral vein for culture. The pathogen was identified as K. ohmeri using the Vitek YST card (bioMérieux, France) and was confirmed by the sequencing of the D1/D2 domains of the 26S rRNA gene and the internally transcribed spacer region. The minimal inhibitory concentrations of the antifungal agents were as follows: amphotericin B 0.5 µg/mL; fluconazole 2 µg/mL; voriconazole ≤ 0.12 µg/mL; fluocytosine ≤ 1 µg/mL. According to the Clinical and Laboratory Standard Institute recommended breakpoint for Candida spp, the isolate was susceptible to fluconazole, amphotericin B, voriconazole, and flucytosine. This is the first report of the isolation of K. ohmeri in the patient with a gastrointestinal neoplasm following ERCP.

Keyword

kodamaea ohmeri; fungemia; carcinoma of the ampulla of Vater; 26S rRNA gene; internal transcribed spacer

MeSH Terms

Aged
Amphotericin B
Ampulla of Vater*
Antifungal Agents
Candida
Cholangiopancreatography, Endoscopic Retrograde
Endocarditis
Fluconazole
Flucytosine
Fungemia*
Fungi
Gastrointestinal Neoplasms
Genes, rRNA
Humans
Immunocompromised Host
Peritonitis
Pichia
Stents
Urinary Tract Infections
Veins
Voriconazole
Yeasts
Amphotericin B
Antifungal Agents
Fluconazole
Flucytosine
Voriconazole