Candida Ciferrii

Candida ciferrii is a species of the candida fungus family and until recently was not thought to be a cause of yeast infections in humans. However there have been recent cases that show it being responsible for some systemic yeast infections. Systemic or invasive means it spreads through the body and can enter the bloodstream where it can attack internal organs. Systemic candidiasis is particularly a problem for patients in hospital in intensive care, who already have immune systems compromised either from their illness or from surgery or from treatment. For example those most at risk are HIV and AIDS patients, organ transplant patients, and cancer patients undergoing chemotherapy.

Fluconazole resistant
The problem with patients who suffer with an invasive yeast infection caused by candida ciferrii is that this species is resistant to common invasive anti-fungal drug treatments like Fluconazole. For example in a case with a patient who had myelod leukaemia they suffered a relapse and after autologous peripheral blood progenitor cell transplantation.

When erythematous skin papulae and spotted pulmonary infiltrations were found a skin biopsy was performed and the invasive candidiasis was diagnosed. In vitro the causing yeast was found to be Candida ciferrii and it was resistant to Fluconazole. The patient died 6 weeks later and lung tissue was taken and incubated. Candida ciferii was confirmed as the causing fungus and it was found in vitro that this species is sensitive to Amphotericin B and itraconazole but gave a confirmed resistance to Fluconazole.

Background of Candida ciferrii
Kreger van Rij was first to describe Candida ciferrii in 1965 and since then until recently it has not been thought to be the cause of any systemic infections in humans. There have been occasional cases of isolated candida ciferrii yeast infections in the elderly found in toe nails of patients with trophic disorders of the legs. Not a lot is known about the natural habitat of candida ciferrii. Here is an outline of a few of the rare cases of candida ciferrii reported in patients.

Case 1 – In 1982 a man was examined in Kansas complaining of a pressure in his ears, headaches, and pain of the esophageal. When examined a white powdery substance was found in his ears. A culture of the material was taken and found to be the fungus Candida ciferrii.

Case 2 – An elderly woman from Honolulu had five cultures taken from her toenails over a one and a half year period. The nails were discolored and distorted. It was a white powdery substance that proved to be candida ciferrii.

Cases 3 to 5 – One patient with white powder in the ear, one a gangrenous foot of a 68 year old woman, and a case of tinea pedis all three had Candida ciferrii.

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