Rhodotorula species fungemia: a threat to the immunocompromised host.

Members of the genus Rhodotorula, family Cryptococcaceae, are common airborne fungi showing remarkable ubiquity. In the recent past they were considered nonvirulent saprophytes. However, during the last two decades they have emerged as opportunistic pathogens in immunocompromised patients. A review of the English literature covering the period 1960-2001 disclosed 47 reported cases of Rhodotorula spp fungemia. The great majority of these infections has been reported after 1990, were catheter-related, and diagnosed in patients with cancer. The treatment of Rhodotorula fungemia remains controversial. Resolution of coexistent neutropenia is essential for recovery. Removal of the central venous catheter is usually sufficient and treatment with systenic antifungals may not be required. If catheter removal is undesirable or impossible or when the infection persists, treatment with amphotericin B is the treatment of choice. Rhodotorula is a fungus with a low virulence and fatality rate. Hence, most patients with Rhodotorula fungemia reported in the literature survived with or without administration of antifungal agents.