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A case report of fungemia due to Kodamaea ohmeri



Kodamaea ohmeri is a yeast is frequently mistaken for Candida, which belongs to the same family. This micro-organism has been reported to cause life-threatening infections in humans.

Case presentation

A 81-year-old woman developed a severe fungemic pulmonary infection due to Kodamaea ohmeri that was identified from bronchoalveolar fluid and blood cultures, which is unusual in immunocompetent patients. Because K. ohmeri was first wrongly identified as Candida albicans, the patient inadequately received caspofungin, which was clinically ineffective, especially as the strain was resistant to echinocandins. Clinical cure was obtained after treatment was switched to voriconazole.


An increasing number of serious infections due to K. ohmeri has been reported in the literature, but the correct identification of this micro-organism remains difficult.

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Kodamaea ohmeri, previously known as Pichia ohmeri, belongs to the Ascomycetae class and the Saccharomycetaceae family. It is the teleomorphic form of Candida guilliermondii [1]. This yeast is frequently mistaken for Candida, which belongs to the same family [2]. It has been first described in tree barks, fruits and cucumber salts used in the food industry for the fermentation of pickled foods. It has also been isolated from environmental sources such as pools, sand, floors and sea water [2]. Since 1984, this micro-organism has been reported to cause life-threatening infections in humans. An increasing number of serious infections has been reported in the literature. We herein report on a new case.

Case presentation

A 81-year-old woman was admitted to the emergency room on January 19th, 2018 for fever and vomiting. Her medical history consisted only in mild cognitive disorders and she received no treatment. Her temperature was 39.2 °C, the oxygen saturation while breathing room air was 88%, and clinical examination was remarkable for rhonchi, extracellular dehydration, fecal impaction, and poor oral condition. Total white blood cell count was 12.7 G/L (PMN 11.2 G/L), serum creatinine, sodium and calcium were 179 μmol/L, 149 mmol/L, and 2.04 mmol/L, respectively. Serum C-reactive protein was 613 mg/L. Liver and pancreatic parameters were normal. Serum CPK and LDH levels were 490 IU/L and 1239 IU/L, respectively. Total body CT-scan showed bilateral basal pulmonary condensations associated with interstitial infiltrates in the upper lobes, as well as an excavated condensation in the right upper lobe and non-complicated colonic diverticulosis. Amoxicillin-clavulanate was started on an empirical basis and the patient was admitted to the pneumology department. Sputum smears were repeatedly negative for acid-fast bacilli. Several blood cultures drawn within the first 3 days remained negative. Urinalysis was negative as were antigenuria for Legionella pneumophila and Streptococcus pneumoniae. Serologies were negative for HIV, HCV, and HTLV-1/2 and positive for anti-HBs antibodies. Because of persisting fever after 10 days of antibiotic treatment, a bronchoscopy was performed, which found diffuse bronchomalacia and no visible tumor. Lavage fluid culture was positive for Staphylococcus aureus (104 CFU/mL) and Candida spp. (103 CFU/mL). The latter contained two populations that were first identified as C. albicans and a C. parapsilosis. The infection was not catheter related, and no other primary focus was identified. Oral fluconazole was started on February 1st. On February 6, while the patient remained febrile, an aerobic blood culture was positive for a yeast after 28 h of growth. Intravenous caspofungin was started. The yeast was identified as K. ohmeri with API 20C System, which led to re-identify the strain of Candida albicans that had been cultured from the BAL fluid as K. ohmeri. With E-test method, the strain was found to be resistant to fluconazole (MIC 4 mg/L) and caspofungin (MIC > 2 mg/L) but sensitive to voriconazole (MIC 0.05 mg/L) and amphotericin B (MIC 0.09 mg/L). Antifungal therapy was switched to voriconazole 4 mg/kg/day. All subsequent blood cultures were negative. Transthoracic echocardiography showed no image consistent with endocarditis. The patient became afebrile and was weaned from oxygen within a few days and voriconazole was discontinued after 10 days. The treatment was stopped by the physicians while the outcome was favourable.


This patient presented with a fungemic infection due to K. ohmeri. The outcome was favorable after introduction of voriconazole.

K. ohmeri is a yeast known to cause invasive infections [3]. In the literature, we identified 73 cases of fungemia due to K. ohmeri [2, 4, 5], 2 cases of peritonitis [6, 7], 3 cases of endocarditis [8,9,10], one case of urinary tract infection [11], one case of cellulitis [12].

In most of these cases, patients were immunosuppressed because of hematologic or solid malignancies, post-chemotherapy neutropenia, immunosuppressive treatments, diabetes, or chronic renal failure [13]. Many cases were catheter-related, and catheter removal was key to cure. Pre-exposure to systemic antibiotics was also reported in many cases [4]. Systemic infections due to K. ohmeri are rarely reported in immunocompetent subjects [14].

On solid media, K. ohmeri forms Candida-like colonies and change their color from pink to blue within 48 h on CHROMagar as do Candida spp. which explains why K. ohmeri may often be mistaken for Candida spp. K. ohmeri is usually resistant to fluconazole and sensitive to amphotericin B [15]. It is also usually sensitive to echinocandins [13], which was not the case in our case.

According to the Clinical Practice Guideline for the Management of Candidiasis of the Infectious Diseases Society of America, an echinocandin is recommended as initial therapy [16]. Fluconazole, 800 mg (12 mg/kg) loading dose, then 400 mg (6 mg/kg) daily, is an alternative for patients who are not critically ill and have had no prior exposure to azoles. In our case, none of these first-line treatments used for candidemia were effective.

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  1. Yamada Y, Suzuki T, Matsuda M, Mikata K. The phylogeny of Yamadazyma ohmeri (Etchells et bell) billon-grand based on the partial sequences of 18S and 26S ribosomal RNAs: the proposal of Kodamaea gen. nov. (Saccharomycetaceae). Biosci Biotechnol Biochem juin. 1995;59:1172–4.

    Article  CAS  Google Scholar 

  2. Chakrabarti A, Rudramurthy SM, Kale P, Hariprasath P, Dhaliwal M, Singhi S, et al. Epidemiological study of a large cluster of fungaemia cases due to Kodamaea ohmeri in an Indian tertiary care centre. Clin Microbiol Infect. 2014;20:O83–9.

    Article  CAS  Google Scholar 

  3. Janvier F, Bensalah M, Abi R, Gil C, Soler C, Mérens A. Invasive infection due to Kodamaea ohmeriMed Mal Infect oct. 2012;42:527–9.

    Article  CAS  Google Scholar 

  4. Kanno Y, Wakabayashi Y, Ikeda M, Tatsuno K, Misawa Y, Sato T, et al. Catheter-related bloodstream infection caused by Kodamaea ohmeri: a case report and literature review. J Infect Chemother. 2017;23:410–4.

    Article  Google Scholar 

  5. Tzar MN, Shamim AS. Candidaemia and antifungal susceptibility testing in a teaching hospital. Med J Malaysia. 2009;64:61–4.

    CAS  PubMed  Google Scholar 

  6. Choy BY, Wong SS, Chan TM, Lai KN. Pichia ohmeri peritonitis in a patient on CAPD: response to treatment with amphotericin. Perit Dial Int. 2000;20:91.

    CAS  PubMed  Google Scholar 

  7. García-Tapia A, García-Agudo R, Marín P, Conejo JL, García-Martos P. Kodamaea ohmeri fungemia associated with surgery. Rev Iberoam Micol. 2007;24:155–6.

    Article  Google Scholar 

  8. Sundaram PS, Bijulal S, Tharakan JA, Antony M. Kodamaea ohmeri tricuspid valve endocarditis with right ventricular inflow obstruction in a neonate with structurally normal heart. Ann Pediatr Cardiol. 2011;4:77–80.

    Article  Google Scholar 

  9. João I, Duarte J, Cotrim C, Rodrigues A, Martins C, Fazendas P, et al. Native valve endocarditis due to Pichia ohmeri. Heart Vessels. 2002;16:260–3.

    Article  Google Scholar 

  10. Reina JP, Larone DH, Sabetta JR, Krieger KK, Hartman BJ. Pichia ohmeri prosthetic valve endocarditis and review of the literature. Scand J Infect Dis. 2002;34:140–1.

    Article  Google Scholar 

  11. Puerto JL, García-Martos P, Saldarreaga A, Ruiz-Aragón J, García-Agudo R, Aoufi S. First report of urinary tract infection due to Pichia ohmeri. Eur J Clin Microbiol Infect Dis. 2002;21:630–1.

    Article  CAS  Google Scholar 

  12. Yang B-H, Peng M-Y, Hou S-J, Sun J-R, Lee S-Y, Lu J-J. Fluconazole-resistant Kodamaea ohmeri fungemia associated with cellulitis: case report and review of the literature. Int J Infect Dis IJID. 2009;13:e493–7.

    Article  CAS  Google Scholar 

  13. Shang S-T, Lin J-C, Ho S-J, Yang Y-S, Chang F-Y, Wang N-C. The emerging life-threatening opportunistic fungal pathogen Kodamaea ohmeri: optimal treatment and literature review. J Microbiol Immunol Infect. 2010;43:200–6.

    Article  CAS  Google Scholar 

  14. Shaaban H, Choo HF, Boghossian J, Perez G. Kodamaea ohmeri fungemia in an immunocompetent patient treated with micafungin: case report and review of the literature. Mycopathologia. 2010;170:223–8.

    Article  Google Scholar 

  15. Desnos-Ollivier M, Robert V, Raoux-Barbot D, Groenewald M, Dromer F. Antifungal susceptibility profiles of 1698 yeast reference strains revealing potential emerging human pathogens. PLoS One. 2012;7:e32278.

    Article  CAS  Google Scholar 

  16. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, et al. Clinical practice guideline for the Management of Candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62:e1–50.

    Article  Google Scholar 

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We thank the department of Pneumology, Microbiology and Infectious diseases of University Hospital of Pointe à Pitre.


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KD drafted the manuscript. BL, GC, JCG, FG, MN and BH revised it critically for important intellectual content. All authors read and approved the final manuscript.

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Correspondence to K. Diallo.

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Diallo, K., Lefevre, B., Cadelis, G. et al. A case report of fungemia due to Kodamaea ohmeri. BMC Infect Dis 19, 570 (2019).

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