SHM Converge Scientific Abstract ePoster Gallery-Saccharomyces Cerevisiae Fungemia in a Critically Ill Patient With Covid-19 Infection and Mdro Pneumonia

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This case report describes a rare but serious instance of <em>Saccharomyces cerevisiae</em> fungemia in an 88-year-old nursing home resident hospitalized with COVID-19 and multidrug-resistant <em>Acinetobacter baumannii</em> pneumonia. The patient presented with worsening dyspnea, copious secretions, and respiratory distress, requiring intubation in the emergency department. Laboratory testing showed anemia, leukopenia, thrombocytopenia, hyperkalemia, and elevated procalcitonin. He was started on cefiderocol, norepinephrine, and propofol.

Blood cultures later grew <em>S. cerevisiae</em>, and the patient was treated with micafungin. Imaging revealed an important potential source of infection: his PEG tube traversed the distal transverse colon before entering the stomach, suggesting a compromised gastrointestinal barrier as the likely route of fungal entry. Although he had been receiving tube feeds for ten days without immediate problems, this abnormal tube placement was considered the most plausible cause of fungemia. No probiotic use was identified on medication review.

The report reviews known risk factors for invasive <em>Saccharomyces</em> infection, including ICU admission, antibiotic exposure, indwelling catheters, total parenteral nutrition, and immunosuppression. It also emphasizes that probiotic products containing <em>S. boulardii</em> can be associated with fungemia, especially in critically ill patients.

The authors conclude that <em>S. cerevisiae</em> fungemia is uncommon but potentially life-threatening and should be recognized promptly. Clinicians should assess for risk factors, ask specifically about probiotic use, and manage suspected cases with antifungal therapy plus removal of potential sources of infection when possible.

Asset Subtitle

Sara Hassan

Meta Tag

Author List Bassam Hasan, Dhiren Shah, Sara Hassan

Category Clinical Vignettes

Concept Saccharomyces cerevisiae fungemia

Concept Invasive Fungal Infection

Concept Probiotic use

Concept Antifungal Therapy

Concept Risk Factor

Distinguished Non-Finalist

Presenter Organization Ocean University Medical Center

Presenting Author Sara Hassan

Track Adult

Keywords

Saccharomyces cerevisiae

fungemia

COVID-19

Acinetobacter baumannii

PEG tube malposition

gastrointestinal barrier

micafungin

probiotic use

intensive care unit

bloodstream infection

Saccharomyces cerevisiae fungemia

Invasive Fungal Infection

Probiotic use

Antifungal Therapy

Risk Factor