A rare case of fungemia by Kodamea ohmeri in a premature infant

Abstract

Background: Kodamaea ohmeri, is part of the Saccharomycetes that commonly used in the processing of fermented foods, but this fungus can be an emergency when it comes to patients with impaired immune systems so that fungiemia, endocarditis, peritonitis can occur. Many cases have been reported in Asia, America and Europe. This case report aims to present a rare case of fungemia caused by Kodamera ohmeri in a premature infant in neonatal intensive care unit (NICU), Prof. Dr. I.G.N.G. Ngoerah, Bali, Indonesia Case presentation: The baby was born prematurely at 33 weeks of gestation because the mother had severe preeclampsia. The baby was admitted to the NICU with an initial diagnosis of sepsis, then blood cultures were taken and inoculated with sabouraud dextrose agar (SDA) at 37°C for 48 hours. Microscopic examination with lactophenol cotton blue staining was carried out from slide culture for 7 days in which clustered yeast cells were found.  Culture results on Saboraud Dextrose Agar (SDA) at 37˚C for 48 hours found growth of colonies that were rough, dry, and white like ivory. Identification results using VITEK-2 compact (bioMérieux®) found Kodamea ohmeri, but no antibiotic sensitivity (AST) results. The patient was treated with fluconazole empirically for 11 days, but not routinely therefore the patient got into emergency condition and died. Conclusion: Patient’s condition eventually worsened, possibly due to the ineffective and inappropriate use of fluconazole. The condition of premature babies, most of whom are immunocompromised, can increase the severity of the disease to sepsis and eventually death.