Candida kefyr菌血症をきたした腎盂腎炎の1例

We encountered a case of Candida kefyr fungemia with pyelonephritis. C. kefyr was first isolated from a dairy kefir in Caucasus in 1909 and was originally named Saccharomyces fragilis. C. kefyr has been reported to be detected in the urine and blood of immunocompromised patients and patients with hematologic malignancies. The patient reported herein, an 89-year-old woman, visited our hospital with the chief complaints of abdominal pain and fever. She was treated by ureteral stent placement and started on PIPC/TAZ for calculous pyelonephritis caused by K. pneumoniae. The clinical course was satisfactory, however, on the 15th day of hospitalization, she again developed lower abdominal pain, blood examination revealed increased levels of inflammatory markers, and C. kefyr was detected in blood and urine cultures. She was treated with L-AMB and FLCZ and discharged in good general condition. In recent years, the frequency of isolation of non-albicans Candida spp. has increased, and the incidence of C. kefyr candidemia has increased worldwide. A search of the literature to the best of my ability failed to identify the number of cases reported in Japan, and many uncertainties remain as to the epidemiology and drug susceptibility; therefore, further study of a larger number of cases is necessary in the future.