Discussion:
Rhodotorula remains a rare cause of infection. Previous reports of disease caused by Rhodotorula have primarily been found in immunocompromised hosts— such as the patient presented here with CVID — with a majority of these involving CVC - associated infections. As it is still not clear why some immunocompromised patients develop complications such as Rhodotorula meningitis or endocarditis whereas others simply have fungemia, patient history and clinical presentation alone may not converge on Rhodotorula . Thus, histopathologic evaluation remains essential to confirming diagnosis and, as in this case, determining treatment course. There remains no definitive treatment algorithm for Rhodotorula : suggested treatments include simple supportive care, fluconazole, various formulations and dosing regimens of amphotericin B, and flucytosine/itraconazole combinations. As seen in our patient, these regimens often cause complications due to their toxicities. Additionally, this patient’s comorbidities, especially her coexisting respiratory failure, were felt to have contributed to her poor outcome. We hope the contribution of this novel manifestation ofRhodotorula as causing brain abscesses nonetheless serves as another datapoint to hopefully improving the diagnosis and management of this rare disease.