Torulopsis glabrata pelvic abscess and fungemia.

Abstract

Serious infections caused by Torulopsis glabrata, once rarely encountered, have become common over the last 3 decades. The most frequent manifestations of serious fungal infections include septicemia, endocarditis, hepatosplenic infections, and meningitis. We report a case of fungemia and pelvic abscess caused by T glabrata following gynecologic surgery. A 43-year-old woman developed fever, abdominal pain, and abdominal distention following a total abdominal hysterectomy and right salpingo-oophorectomy. Empirical treatment with broad-spectrum antimicrobial agents was not successful. Three sets of blood cultures were positive for T glabrata, and radiologic investigations revealed pelvic and lesser sac fluid collections. Cultures of the pelvic abscess grew T glabrata. Treatment was changed to amphotericin B, with complete clinical recovery. Serious T glabrata infections are rare following gynecologic surgery, especially in immunocompetent patients. Given the morbidity and mortality associated with these infections, aggressive treatment with amphotericin B and drainage of abscesses is warranted.