Kodamaea Ohmeri: a rare fungus causing a severe case of necrotizing fasciitis

Mercy Jimenez, Emily S. Seltzer, Javeria Shakil, Martine Louis


Necrotizing soft tissue infection, NSTI, involves the soft tissue characterized by rapid spread of infection and consequent cell necrosis. NSTI, in particular necrotizing fasciitis (NF), is a significant disease burden in the US with an annual mortality of 4.8 per 1,000,000 person years. Here we describe a rare fungal pathogen, Kodamaea Ohmeri, as a cause of NF in a diabetic but otherwise healthy male patient. In the past K. Ohmeri has been described in children, immunocompromised individuals, and in cases with IV catheters and prolonged use of IV antibiotics. A febrile and hypotensive male (LRINEC score of 6) presented after sustaining abrasions of his right lower extremity. He was initially started on broad-spectrum antibiotics and underwent surgical exploration. During the following weeks, the patient developed sepsis and endured a total of four debridement. Wound cultures resulted K. Ohmeri with sensitivity to miconazole and voriconazole. Anti-fungal, silver dressings and wound vacuum, were utilized to assist in treatment and tissue granulation. To our knowledge, this is the first case describing Kodamea ohmeri as a causative agent of NF. K. Ohmeri should be on the radar of the health care providers taking care of patients with NF, especially in the context of intermittent bouts of sepsis and prolonged hospital course. Our case illustrates the fact that prompt identification, addition of fungal cultures and appropriate surgical treatment are crucial to improve patient outcomes.


Necrotizing fasciitis, Kodamaea Ohmeri, Case report

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Arif N, Yousfi S, Vinnard C. Deaths from necrotizing fasciitis in the United States, 2003-2013. Epidemiology Infection. 2016;144(6):1338-44.

Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A. Current concepts in the management of necrotizing fasciitis. Frontiers Surg. 2014;1:36.

Bergman M, Gagnon D, Doern GV. Pichia Ohmeri fungemia. Diagnostic Microbiology Infectious Disease. 1998;30(3):229-31.

Socarras AJ, Torres RJP, Soler VJA, Guerrero C. Infeccion por Kodamaea Ohmeri en un recien nacido con una masa mediastinal. Archivos Argentinos de Pediatria. 2016;114(5):319-22.

Vivas R, Beltran C, Munera MI, Trujillo M, Restrepo A, Garces C. Fungemia due to Kodamaea Ohmeri in a young infant and review of the literature. Medical Mycology Case Reports. 2016;13:5-8.

Aldeen TS, Doiphode S, Han X. Kodamaea (Pichia) ohmeri fungaemia in a premature neonate. J Med Microbiology. 2006;55(2):237-9.

Menon T, Herrera M, Periasamy S, Palanivelu V, Sikhamani R, Wickes B. Oral candidiasis caused by Kodamaea Ohmeri in a HIV patient in Chennai, India. Mycoses. 2010;53(5):458-9.

Ni B, Gu W, Mei Y, Miao K, Zhang S, Shao Y. A Rare Life-threatening Kodamaea Ohmeri Endocarditis Associated with Hemophagocytic Lymphohistiocytosis. Revista Espanola de Cardiologia. 2018;71(01):51-3.

Tashiro A, Nei T, Sugimoto R. Kodamaea Ohmeri fungemia in severe burn: case study and literature review. Medical Mycology Case Reports. 2018;22:21-3.

Mahfouz RA, Otrock ZK, Mehawej H, Farhat F. Kodamaea (Pichia) Ohmeri fungaemia complicating acute myeloid leukaemia in a patient with haemochromatosis. Pathology. 2008;40(1):99-101.

Capoor M, Gupta D, Verma P, Sachdeva H. Rare yeasts causing fungemia in immunocompromised and haematology patients: case series from Delhi. Indian J Med Microbiology. 2015;33(4):576.

Chiu CH, Wang YC, Shang ST, Chang FY. Kodamaea Ohmeri fungaemia successfully treated with caspofungin. International J Anti-microbial Agents. 2010;35(1):98-9.

Distasi M, Gaudio DT, Pellegrino G, Pirronti A, Passera M, Farina C. Fungemia due to Kodamaea Ohmeri: first isolating in Italy. Case report and review of literature. J Med Mycology. 2015;25(4):310-6.

Kanno Y, Wakabayashi Y, Ikeda M. Catheter-related bloodstream infection caused by Kodamaea Ohmeri: A case report and literature review. J Infection Chemotherapy. 2017;23(6):410-4.

Ruiz FM, Guinea J, Asensio PM. Fungemia due to rare opportunistic yeasts: data from a population-based surveillance in Spain. Med Mycology. 2016;55(2):125-36.

Imbert J, Gomez J, Escudero R, Blasco J. Onicomicosis por levaduras no comunes en diabeticos de un centro de salud. SEMERGEN Med de Familia. 2016;42(7):449-57.

Chander J, Stchigel AM, Izquierdo AA. Fungal necrotizing fasciitis, an emerging infectious disease caused by Apophysomyces (Mucorales). Revista Iberoamericana de Micologia. 2015;32(2):93-8.

Chander J, Singla N, Kaur M. Saksenaea erythrospora, an emerging mucoralean fungus causing severe necrotizing skin and soft tissue infections–a study from a tertiary care hospital in north India. Infectious Diseases. 2017;49(3):170-7.

Lee JS, Shin JH, Kim MN. Kodamaea Ohmeri isolates from patients in a university hospital: identification, antifungal susceptibility, and pulsed-field gel electrophoresis analysis. J Clin Microbiology. 2007;45(3):1005-10.

Santino I, Bono S, Borruso L. Kodamaea Ohmeri isolate from two immunocompromised patients: first report in Italy. Mycoses. 2013;56(2):179-81.

Yang BH, Peng MY, Hou SJ, Sun JR, Lee SY, Lu JJ. Fluconazole resistant Kodamaea Ohmeri fungemia associated with cellulitis: case report and review of the literature. Int J Infectious Diseases. 2009;13(6):493-7.

Eddouzi J, Lohberger A, Vogne C, Manai M, Sanglard D. Identification and antifungal susceptibility of a large collection of yeast strains isolated in Tunisian hospitals. Med Mycology. 2013;51(7):737-46.

Shang ST, Lin JC, Ho SJ, Yang YS, Chang FY, Wang NC. The emerging life-threatening opportunistic fungal pathogen Kodamaea Ohmeri: optimal treatment and literature review. J Microbiology Immunology Infection. 2010;43(3):200-6.