Abstract
Introduction: Rhodotorula species are widespread in nature and can be isolated from a variety of sources, including air, soil, seawater,
plants, and the household environment. They are also widely distributed in hospitals, and their presence could be considered a
risk factor for hospitalized patients. These commensal yeasts have emerged as a cause of life-threatening fungemia in patients with
depressed immune systems.
Case Presentation: We report a case of duodenal perforation with peritonitis in a 36-year-old female who was scheduled immediately
for exploratory laparotomy followed by closure of perforation and omentopexy. The peritoneal fluid was sent to the microbiology
laboratory for routine investigations. On the 4th postoperative day, the patient had a fever that did not subside with antipyretics;
hence, blood cultures were sent the next day. The peritoneal fluid and blood culture reports both yielded Rhodotorula mucilaginosa
after 3 days of incubation. The patient was started on IV amphotericin B therapy, which resulted in a favorable outcome.
Conclusions: In humans, Rhodotorula species have been recovered as commensal organisms from the nails, the skin, and the respiratory,
gastrointestinal (GI), and urinary tracts. Due to their presence in the GI flora, broad-spectrum antibiotics could contribute to
their overgrowth in the GI tract. Localized infections, such as peritonitis, due to Rhodotorula species following infected peritoneal
dialysis catheters have been reported in the literature. However, in our case, it seems possible that the fungus might have entered
the bloodstream through disruption of the GI mucosa, and to prove this, further study is mandatory. It should also be noted that
both amphotericin B and flucytosine have good activity against Rhodotorula in vitro, whereas fluconazole is inactive.