Clinical and microbiological features of infection with Malassezia pachydermatis in high-risk infants.

Malassezia pachydermatis, a yeast that has not previously been implicated as a cause of human disease, was isolated from cultures of blood from three infants. All infants were 25-27 w of gestational age and had multiple underlying medical problems. The infants had been hospitalized for at least six weeks, had received broad-spectrum antibiotics, and had received parenteral lipid nutrition via a central venous catheter. In one patient, fungemia was accompanied by clinical and laboratory evidence of Broviac catheter infection. During a three-year period, M. pachydermatis was also recovered from fungal cultures of an additional 30 patients, 85% of whom were infants. A pathogenic role for M. pachydermatis recovered from sources other than blood or catheters was not established. Risk factors for and symptoms in infants with M. pachydermatis fungemia appeared to be similar to those described for Malassezia furfur sepsis.