Authors
Nobuaki Mori, Kana Matsumoto, Ryosuke Shoji, Emiko Mura, Kazuhiko Oshinomi, Yasuyuki Ohira, Masahiro Abe, Ami Koizumi, Masahito Oda, Masayuki Maeda, Keiko Ishino, Issei Tokimatsu
Published in
Medical mycology journal. Volume 67. Issue 3. Pages 193-197.
Abstract
We describe a male in his fifties with a refractory azole-resistant Candida albicans renal and perirenal walled-off abscess. C. albicans developed acquired azole-resistance during fluconazole (FLCZ) therapy. Despite FLCZ penetrating the walled-off abscess (11.1 μg/g) with levels exceeding those in normal renal tissue, the infection persisted, necessitating nephrectomy. Despite no amino acid substitutions in the ERG11 gene as revealed by genetic analysis, a Rhodamine 6G assay demonstrated a 4.5- to 6.6-fold increase in efflux activity in the resistant isolates in comparison with the susceptible controls, suggesting efflux pump-mediated resistance. Following surgery, the patient developed emphysematous pyelonephritis in the contralateral kidney due to azole-resistant C. albicans. This case demonstrates that even substantial tissue penetration cannot overcome high-level, effluxmediated resistance within walled-off lesions, underscoring the critical importance of surgical source control.
PMID:
42669481
Bibliographic data and abstract were imported from PubMed on 31 Aug 2026.
Read full publication at:
Please sign in
to see all details.
Advertisement
Stats
- Recommendations n/a n/a positive of 0 vote(s)
- Views 7
- Comments 0