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Candidemia due to Candida lambica in a neutropenic oncology patient: A rare case report

Summary

A 56-year-old cancer patient developed a serious bloodstream infection caused by a rare yeast called Candida lambica despite taking antifungal medications. Doctors identified the infection using genetic sequencing and found that the organism was sensitive to a different antifungal drug called voriconazole. After switching medications and removing the patient’s central line, the infection cleared up. This case demonstrates the importance of accurately identifying fungal infections and testing which medications work best against them.

Background

Candidemia caused by non-albicans Candida (NAC) species is an emerging concern in immunocompromised patients. Candida lambica is a rare yeast species that has been frequently misidentified as Candida krusei due to morphological similarities. This case documents the clinical presentation and management of C. lambica candidemia in an acute myeloid leukemia patient.

Objective

To report the first documented case of C. lambica candidemia in Iran and provide a comprehensive review of the literature on C. lambica fungemia in immunocompromised hosts. The study emphasizes the importance of accurate species identification and appropriate antifungal therapy selection.

Results

Blood cultures yielded yeast growth identified as C. lambica through ITS sequencing (GenBank accession OP658919.1). The isolate demonstrated susceptibility to amphotericin B, voriconazole, itraconazole, and caspofungin. Following initiation of voriconazole therapy and central venous catheter removal, blood cultures became negative on day 14, with partial clinical improvement achieved.

Conclusion

This case highlights the emerging clinical relevance of rare NAC species in immunocompromised hosts and demonstrates the critical importance of molecular identification tools and antifungal susceptibility testing in guiding effective treatment. Advanced diagnostic methods are essential to avoid misidentification with fluconazole-resistant species like C. krusei.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 40747298, DOI: 10.1016/j.mmcr.2025.100720
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