FEBRILE INFANT WITH A PERCUTANEOUS VASCULAR CATHETER

A 10-week-old male infant with Hirschsprung disease was evaluated for a 1-month history of intermittent fever. Review of a blood smear from a sample drawn through the percutaneous line showed yeast forms at the feather edge compatible with Malassezia furfur. Specific steps were then taken to isolate the organism in culture; blood was drawn through the catheter and collected in an Isolator 1.5 tube (Wampole Laboratories, Cranbury, NJ) and then inoculated on blood agar with an olive oil overlay. The organism grew in culture within 48 hours. In our patient we attempted to treat the infection with high dose amphotericin with the line in place. After amphotericin for 2 weeks blood cultures obtained through the catheter remained positive for M. furfur. The catheter was then removed; all subsequent cultures were negative for M. furfur.