Risk factors in a patient with fungemia caused by fluconazole-resistant Candida albicans

Blood stream infections due to Candida species are becoming increasingly important causes of morbidity and mortality in hospitalized patients. Risk factors that predispose patients to developing invasive Candida infections have been documented as, iatrogenic and/or nosocomial conditions and immunosuppression. In the present report, we want to emphasize the risk factors that predispose individuals to the development of candidemia, particularly those that are relevant to our patient. We describe a female patient with diabetes mellitus who had been receiving glucocorticoids for 20 years as replacement therapy for hypopituitarism resulting from hypophysis adenoma surgery. The patient received antibiotic therapy for recurrent wound infections and was hospitalized for a long time, including a period in the intensive care unit and instrumented. The patient eventually succumbed to fungemia caused by a fluconazole-resistant strain of C. albicans strain.