Systemic <em>Malassezia furfur</em> infections in patients receiving intralipid therapy

Systemic infection with Malassezia furfur was first reported in 1981 as a specific complication of Intralipid therapy in a neonate. Six additional patients, including three older than 16 years of age, were identified subsequently. All had received prolonged Intralipid infusion through central venous catheters. Pulmonary infection was documented in tissue in three cases; the clinical presentation was characterized by pulmonary infiltrates, fever, and, in the infants, thrombocytopenia. Two subgroups of patients appear to be at the greatest risk for Malassezia infection: neonates with cardiopulmonary disease and adults with severe gastrointestinal disease and immunosuppression. The documentation of pulmonary arterial lipix deposits in vessels that had been infiltrated by Malassezia organisms and the observation of organisms in small pulmonary thromboemboli suggest that these lipophilic and lipid-dependent organisms are introduced into the bloodstream from venous catheters and require high lipid concentrations to proliferate in tissue.

1981年首次报道了新生儿因接受英脱利匹特（Intralipid，一种脂肪乳剂）治疗而发生的马拉色菌（Malassezia furfur）系统性感染这一特殊并发症。随后又发现了另外6例患者，其中包括3例年龄超过16岁的患者。所有患者都通过中心静脉导管长时间输注英脱利匹特。在3例患者的组织中记录到肺部感染；临床表现为肺部浸润、发热，婴儿还伴有血小板减少。两类患者似乎感染马拉色菌的风险最高：患有心肺疾病的新生儿以及患有严重胃肠道疾病和免疫抑制的成年人。在被马拉色菌浸润的血管中发现肺动脉脂质沉积，以及在小的肺血栓栓塞中观察到该菌，这表明这些亲脂且依赖脂质的微生物从静脉导管进入血液，并需要高脂质浓度才能在组织中增殖。