Doctors treat 2-month-old boy with rare yeast infection

Doctors have successfully treated a two-month-old boy suffering from a rare yeast infection called Rhodoturula coupled with Cytomegalovirus (CMV) Meningitis.

"This is the world's first reported case of Rhodoturula infection (Rhodotorula is a genus of pigmented yeasts), while the CMV Meningitis is the second such reported case in the world as per the available medical records," doctors at the Fortis Hospital, Noida, said in a statement on Tuesday.

CMV Meningitis is an infection and inflammation of the lining of the brain. Also known as HCMV, CMV, or human herpesvirus 5 (HHV-5), is the most commonly transmitted virus to a developing foetus.

The baby, born to residents of Mathura, Uttar Pradesh, was admitted to the hospital with fever, increased irritability and two episodes of abnormal movements, including up-rolling of eyes, bulging in the top of the head and irritable cry.

Several medical tests such as MRI, CSF (cerebrospinal fluid) etc. were conducted to identify any underlying infection, which revealed that the baby had Meningitis. Owing to the uncontrolled seizures, the baby was intubated and administered antibiotics.

Clinically, the baby showed improvement with satisfactory feeding and activity, but his high-grade fever was not getting better.

He was having 3-4 episodes of fever everyday, thus a CSF examination was repeated and sent for a BioFire test which returned CMV positive.

Ganciclovir injection was administered for the following six weeks. However, the fever didn't subside even after 10 days. The CSF fungal culture revealed the presence of Rhodotorula infection.

After a repeat CSF fungal culture that "revealed the presence of a rare yeast -- Rhodotorula species -- which has not been identified or observed in CMV anywhere in the world, Amphotericin B was administered for four weeks. This helped the baby recover and his fever also subsided," Ashutosh Sinha, Director & Head, Paediatrics, Fortis Noida, said in a statement.

"Without immediate and correct treatment, the chances of survival were meagre. Initial MRI had shown changes in the brain but subsequent MRI of the brain showed improvement. We discharged the baby in normal condition without any complications. The condition has risk factors - high mortality, neurodisability and other related complications if left undiagnosed and untreated," he added.

CMV is a common virus and once infected, the body retains the virus for life. Most people don't know they have CMV because it rarely causes problems in healthy people. The infection generally happens in immunocompromised and HIV patients or those undergoing chemotherapy.

"There have been cases of CMV infection in babies acquired before birth from mother or after birth through breast milk, but infection of the brain is very rare. Some babies can acquire it after birth via breast milk. However, in this case, it was not possible to ascertain if breast milk was the carrier, although we stopped breast milk to limit the exposure," Sinha said. [IANS/JS]