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

Abstract

We report a rare case of Candida lambica candidemia in a 56-year-old male with acute myeloid leukemia undergoing intensive chemotherapy. Despite fluconazole prophylaxis, the patient developed persistent febrile neutropenia. Blood cultures grew yeast, later identified as C. lambica via ITS rDNA sequencing. Antifungal susceptibility testing revealed sensitivity to voriconazole and other antifungals resulting in clinical improvement following targeted therapy. This case highlights the growing clinical relevance of rare non-albicans candida species in immunocompromised hosts, the limitations of conventional diagnostics, and the importance of molecular tools and antifungal susceptibility testing in guiding effective treatment.

Keywords: Acute myeloid leukemia; Antifungal susceptibility; Candida lambica.

Fig. 1

A and C: On SDA medium, both C. krusei and C. lambica produce cream-colored colonies with similar appearance. B: On CHROMagar Candida medium C. krusei forms dry, pink to purple colonies and D: C. lambica produces colonies with a paler and less distinct purple hue. This similarity in colony morphology highlights the potential for misidentification when relying solely on conventional mycological methods.

Fig. 2

Phylogenetic tree based on the ITS1 and ITS4 gene regions of Candida species using the two-parameter Kimura model in the maximum likelihood algorithm with 1000 bootstrap resampling. Our recorded sequences in this study are highlighted.