Saccharomyces cerevisiae also known as baker's yeast is an asporogenous yeast that is used in the production of beer, wine and baked goods. It is also used as an adjunct in vaccines and can be found in health foods. The first case of S. cerevisiae fungemia was reported in 1970. Subsequent cases reported include fungemia, pneumonia, endocarditis, urinary tract infections and vaginitis. A review of Medline revealed nine other cases of fungemia, none of these had associated skin lesions. We believe this is the first case of S. cerevisiae fungemia presenting as a skin rash in a neutropenic patient. A 42 year old Hispanic man with the diagnosis of acute myeloid leukemia (AML) was transferred from another hospital with fever, chills and night sweats for over a week. He was neutropenic, anemic and thrombocytopenic for over a month after receiving chemotherapy. He drank a few beers occasionally. On admission he was normotcnsivc with a temperature of 101° F, pulse 98/min and respiratory rate 18/min. There were no adenopathy, skin lesions or focal findings. He was started on gentamicin, ceftazidime and vancomycin. A bone marrow biopsy was consistent with relapse of his AML. After receiving a course of chemotherapy, he became afebrile. Seven days after completing his chemotherapy he became febrile, with multiple small nodular skin lesions on his back, chest and neck. Two sets of blood cultures obtained grew Saccharomyces cerevisae. Skin biopsy revealed follicular spongiosis with the collection of yeast adjacent to hair and within the hair follicles. The patient was started on amphotericin B. The skin rash improved and disappeared after a week of therapy. His malignancy appeared to involve his cerebellum. He became depressed and developed dysphasia with cerebellar signs. He refused further treatment ard passed away five weeks after the diagnosis was made.
|Journal||Clinical Infectious Diseases|
|State||Published - Dec 1 1997|
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