Infectious Disease Compendium

Malassezia

Microbiology

A mould, M. furfur, M. globosa, M. obtusa, M. pachydermatis, M. restricta, M. slooffiae, M. sympodialis. Looks like spaghetti and meatballs on a strain.

Epidemiologic Risks

Part of the normal skin, they love lipid (don't we all. mmmmmmmmm fat) and can be found in infections associated with iv lipid.

Syndromes

Pityriasis versicolor, folliculitis and seborrheic dermatitis in normal hosts; intravenous catheter infections in the abnormal hosts, esp with intralipid.

Treatment

For skin disease terbinafine cream OR 2% selenium sulfide lotion, OR 20% sodium thiosulfate qd for 10 to 14 days. In severe cases, oral ketoconazole OR itraconazole.

In disseminated disease and line infections, pull the line and use amphotericin B OR itraconazole. Maybe. It is often resistant to amphotericin and the best bet may be posaconazole or voriconazole, depending in how susceptibility is determined (PubMed).

Notes

I try to avoid ketoconazole due to increased hepatotoxicity.