Learning Moment in Late Night
Once in a while, my colleagues and I notice uncommon names on our MALDI-TOF results. This particular organism came from the urine culture of a middle-aged male.
At first glance, we figured it was a type of fungus. To satisfy our curiosity, we searched the web for Lodderomyces elongisporus. Here are some results from our preliminary digging. (See source1 and source2)
It's a bloodstream pathogen.
It was the teleomorph (sexual state) of Candida parapsilosis until molecular data proved otherwise. The difference is in their rRNA.It's probably safe to assume L. elongisporus has near-identical biochemical and phenotypic qualities compared to C. parapsilosis.
If we check out CDC's list, that's consistent with the claims that they aren't the same organism.
Here's another trait: L. elongisporous produces a pretty turquoise color when growing on Chrome agar.
So, what does it mean for the patient? Since we didn't have a complete history, we couldn't tell he was suffering from fungemia. Although, it's not uncommon to find the same pathogen in a patient's urine if they were to suffer from sepsis.
How did the MALDI-TOF manage to identify this organism? I figured the piece that distinguished it from C. parapsilosis might have been content from the ribosome.
Anyways, it was a learning moment at work.
Posted with STEMGeeks
Wow Interesting! I am still curious how this fungus ended there
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That's always one of the more interesting things to know about the patient.
No idea how it ended up there but it would make a refreshingly interesting post for the Hive fungus community...
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Will he die?
Don’t know. Above my pay grade.
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Guys at the lab: hmmm it seems Vitek raised some interesting flags here.
Me: Fascinating... pulls out phone to Google
Guys at the lab: Needs more test to further identify the subspecies.
Me: Yes.
Guys at the lab: ...
Me: Yeah I know we're not going to investigate further because identifying the subspecies requires more tools, I get it, give the papers and we'll sign this out.
That's my version of your similar story. Limitations of our lab and so on. We just let the clinicians make an educated guess from then on or recommend sending out the specimen to a tertiary lab better equipped. Sounds cool you get more options to use what's written on the textbooks.
I just leave a comment on the report that it behaves similarly to C. parapsilosis while reporting the actual organism.