21 Sept 2023 • 'Don't trust your VITEK'

This is what Dr. Harshad said at the end of one of his case discussions.

VITEK is known to provide rapid, accurate species-level identification of >350 clinically relevant microbes and test their susceptibility to various antimicrobials, then why should we not trust it?🤷‍♀️

Don't worry....lets get you up to speed in a minute 😎

In the session, Invasive Fungal Infections: A Showcase of Intriguing Cases, Dr. Harshad Limaye covers various cases on rare but invasive fungal infections which he encountered at his clinical practice.

In one such unique case, Dr. Limaye talks about a 67 year old woman who is a known case of pulmonary TB 🫁(being treated with AKT), with a PMH significant for:

• Cervical CA post radical hysterectomy with bilateral salpingo -oopherectomy
• Vault brachytherapy
• Subsequent development of radiation induced High grade pleomorphic sarcoma of the Right hemipelvis, for which Right hemipelvectomy was performed successfully.

Now this is when things took a turn for the worse.😦

About a month later, the patient came back complaining of discharge from the surgical site, soon after which a surgical debridement was performed, and multiple samples from the devitalized tissue were sent for culture🧫.

The culture came back positive for Candida guilliermondii and the VITEK revealed susceptibility to Amphotericin B.

'Don't trust your VITEK'

Administering Amphotericin B to the patient who was already on chronic AKT for TB, on a long term basis, was definitely not a good idea.🙅‍♀️

Nonetheless, Dr. Harshad decided to send the samples for MALDI - TOF which revealed Candida auris and as for the antimicrobial susceptibility, a broth microdilution was performed which was inconclusive.

However, evidence🔎 has shown that C.auris is susceptible to Echinocandins in almost 90% of the cases.

So the patient was given Anidulafungin, and she has been responding very well to the treatment. 🥳

Would you like to hear more of these interesting cases?

Click here to learn about some more Intriguing cases of Invasive Fungal Infections with Dr. Harshad Limaye right here on Medflix 💛