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Fungal sepsis in a 7-month-old female: diagnosis through peripheral blood smear

Summary

A 7-month-old girl with persistent fever that did not respond to antibiotics was found to have a yeast infection in her blood through examination of a blood sample under a microscope. This discovery was unusual because such infections are typically difficult to spot without special culture tests. After treatment with the antifungal medication fluconazole, the child recovered completely. This case shows how simple microscopy can help diagnose serious fungal infections in areas where advanced laboratory testing is not available.

Background

Fungal sepsis, particularly candidemia, is a significant cause of healthcare-associated bloodstream infections with high mortality rates. Diagnosis of yeast fungemia through peripheral blood smear examination is rare and requires high fungal burden concentrations. This case report demonstrates the diagnostic value of blood smear review in resource-limited settings.

Objective

To report a case of fungal sepsis in a 7-month-old female diagnosed through peripheral blood smear examination after prolonged fever unresponsive to broad-spectrum antibiotics and antimalarial drugs. The case highlights the utility of blood smear microscopy in identifying yeast infections when culture methods are unavailable.

Results

Peripheral blood smear examination revealed yeast cells on day 28 of illness, with findings confirmed on repeat testing. The patient presented with thrombocytopenia (46 × 10³/μL) and clinical deterioration despite negative cultures and imaging. She responded well to oral fluconazole (12 mg/kg/day) for 14 days with full clinical recovery and normal follow-up findings at 15 days post-discharge.

Conclusion

Peripheral blood smear examination represents a practical diagnostic tool for early recognition of yeast infections in resource-limited settings where advanced fungal testing is unavailable. The case underscores the importance of manual microscopic review in identifying fungal pathogens and the clinical significance of repeated smear examination to distinguish true fungemia from contamination.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 40502536, DOI: 10.1016/j.mmcr.2025.100708
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