In Reply.—Drs Orson and Greco have suggested that the patient we described who had T glabrata sepsis might have had chronic granulomatous disease. Cohen et al1 did report that 20.4% of 245 patients with chronic granulomatous disease developed fungal infections, of which 4% were T glabrata. However, T glabrata infections have also been reported in association with drug addiction. The diagnosis of chronic granulomatous disease should certainly be considered in patients with invasive Torulopsis infections, but it is statistically unlikely in a female child with four healthy older siblings. The absence of tissue granulomata in the liver, spleen, and lymph nodes (at autopsy) effectively excludes chronic granulomatous disease in our patient, even though biochemical tests were not performed. We appreciate Drs Orson and Greco's reminder that chronic granulomatous disease should be considered in patients with Torulopsis infections.
BALEY JE, KLIEGMAN RM, FANAROFF AA, DAHMS BB, ANNABLE WL. Chronic Granulomatous Disease and Torulopsis Infections-Reply. Am J Dis Child. 1985;139(6):545. doi:10.1001/archpedi.1985.02140080015012
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