Cryptococcus laurentii Fungemia in a Premature Neonate

Cryptococcus spp. other than Cryptococcus neoformans are generally considered nonpathogenic to humans. There are only 15 case reports of disease in humans caused by Cryptococcus laurentii infection. Underlying diseases and predisposing risk factors seem to play an important role in these cases. Our patient is the first case of an extremely low birth weight infant with C. laurentii fungemia reported in the English literature. In our case, the MIC of amphotericin B for C. laurentii was 0.25 to 1 μg/ml and the patient had a good outcome following the administration of amphotericin B at 10 mg/kg combined with central venous catheter removal. There will undoubtedly be an increasing occurrence of unusual fungal infections accompanying further advances in medicine. A high degree of suspicion and improvements in the techniques for culture and identification will contribute to the earlier diagnosis and treatment of unusual fungal infections.

除新型隐球菌（Cryptococcus neoformans）外的隐球菌属（Cryptococcus spp.）菌株通常被认为对人类无致病性。目前仅报道有15例由劳伦隐球菌（Cryptococcus laurentii）感染引发人类疾病的病例。此类病例中，基础疾病与易感危险因素似乎起到了关键作用。

本例患者为英文文献中记载的首例合并劳伦隐球菌真菌血症的极低出生体重儿。本病例中，劳伦隐球菌对两性霉素B的最低抑菌浓度（MIC，Minimum Inhibitory Concentration）为0.25~1 μg/ml，患者以10 mg/kg剂量接受两性霉素B治疗联合中心静脉导管拔除后，获得了良好的预后。

随着医学技术的进一步发展，罕见真菌感染的发生无疑将日益增多。提升临床警惕性并优化培养与鉴定技术，将有助于罕见真菌感染的早期诊断与治疗。