<i>Candida dubliniensis</i>Fungemia: the First Four Cases in North America

Abstract

In recent years, Candida species other than C. albicans have emerged as causes of human candidiasis, particularly in HIV-infected and other immunocompromised persons (1). C. dubliniensis, a recently described species closely related to C. albicans (2), has been implicated as an agent of oral candidiasis in HIVpositive persons (2-5) but has also been recovered from HIV-negative persons with clinical signs of oral candidiasis and from the genital tract of some women with vaginitis (2,4). First isolated from AIDS patients in Dublin, Ireland (2), C. dubliniensis has a worldwide distribution (3-6). Most isolates are susceptible to amphotericin B and the azoles, but resistance has been shown in HIV-positive patients on fluconazole for oral candidiasis (7). Its potential to cause deep or disseminated candidiasis is not known, largely because C. dubliniensis has rarely been isolated from sterile body sites (6); however, the phenotypic characteristics the organism shares with C. albicans (producing germ tubes and chlamydospores) suggest that some C. dubliniensis isolates may have been misidentified as C. albicans.