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Rhodotorula rubra causing skin lesions in a HIV positive patient

This paper is available in a repository.
This paper is available in a repository.

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Abstract

Objective. The purpose of this study was to report a case of skin infection caused by Rhodotorula rubra in the groin of a 32-years-old HIV infected homosexual male, which lasted approximately five months. Methods. The yeast was isolated in Sabouraud dextrose agar plus chloramphenicol in three different occasions and the identification of yeast was based on its morphological and physiological characteristics. The fungus was tested for proteinase and phospholipase secretion as well as for susceptibility to antifungals. Results. The yeast was identified as Rhodotorula rubra and no other microorganism could be isolated from the lesion. The fungus presented phospholipase but not proteinase activity. Antifungal susceptibility testing showed that it presented MIC valoues of ≥ 256 μg/ml for fluconazole, ≥ 32 μg/ml for 5-fluorocytosine, 8 μg/ml for ketoconazole and 4 μg/ml for amphotericin B and itraconazole with E-test. In addition, it was sensitive at a 100 I.U. (International Units) concentration of nystatin in diffusion disk test. Conclusions. Topic treatment with nystatin led to the remission of lesions and the elimination of the fungus. In vitro susceptibility results showed that ketoconazole, itraconazole and amphotericin B could have some therapeutical usefulness for this yeast. Production of phospholipase by the fungus could indicate the possible virulence of this isolate. However, care should be done in the interpretation of the epidemiological and clinical meaning of Rhodotorula superficial infections in HIV positive individuals.