Candida tropicalis Recovered from a Bone Marrow Aspirate in a Diabetic Patient

Introduction In recent years, Candida species other than Candida albicans have emerged as more common causes of human disease, particularly in HIVinfected and other immunocompromised individuals (1). Hematogenous dissemination of Candida spp. can produce infection in virtually any organ (2). Normal bone is highly resistant to infection, needing exposure to a large microbial inoculum, trauma, or the presence of a foreign body for initiation of an infection (3). Factors that predispose patients to systemic Candida infection include immunosuppression during the course of anti-cancer therapy, organ transplantation, parenteral hyperalimentation, indwelling arterial/ venous catheters, intravenous drug addiction, diabetes mellitus, broad-spectrum antibiotic therapy, HIV infection, corticosteroid therapy, and myeloperoxidase deficiency (3-7). Direct implantation of Candida spp. is a rare cause of infection (3). Invasive candidiasis occurs mostly in immunocompromised patients and is a severe, life-threatening infection, with a mortality rate comparable to that observed in septic shock patients (40 to 60%) (5). Candida tropicalis accounts for a high incidence of candidemia in intensive care unit patients (8). In this case report, we describe the isolation of C. tropicalis from a bone marrow aspirate collected from a patient suffering from candidemia who had underlying tuberculous (TB) meningitis as a co-morbidity.