Three cases of vulvovaginal candidiasis due to Candida nivariensis

Med Mycol Case Rep. 2024 Feb 27:43:100640. doi: 10.1016/j.mmcr.2024.100640. eCollection 2024 Mar.

Abstract

Candida nivariensis is emerging as a highly resistant species of the Candida glabrata complex causing invasive and mucocutaneous infections. In this study, three cases of vulvovaginal candidiasis caused by C. nivariensis are described and identified by Internal Transcribed Spacer 1-2 sequencing. All isolates were susceptible in vitro to anidulafungin, micafungin, caspofungin, 5-flucytosine, posaconazole, voriconazole, itraconazole, amphotericin B, and showed dose-dependent susceptibility to fluconazole. In two patients, three doses of oral fluconazole were effective, while one patient developed clinical fluconazole resistance with a new relapse after 6 months. Increasing the weekly dose of fluconazole showed to be effective in this patient.

Keywords: Candida nivariensis; Fluconazole; Vulvovaginal candidiasis.