Community-Acquired Kodamaea ohmeri Fungemia in an Immunocompetent Host Coexisting With Severe Leptospirosis: A Case Report and Review of Community-Acquired Fungemia Cases.

Community-acquired fungemia in immunocompetent hosts remains exceptionally rare. Kodamaea ohmeri is an emerging opportunistic yeast pathogen increasingly recognised as a cause of invasive fungal infections, particularly among immunocompromised individuals and in healthcare settings. A 33-year-old previously healthy female farmer presented with severe leptospirosis with multiorgan dysfunction. Blood cultures obtained before central venous catheter insertion grew K. ohmeri, identified by the VITEK 2 YST card and matrix-assisted laser desorption ionisation-time of flight (MALDI-TOF) mass spectrometry. Repeat blood cultures also yielded K. ohmeri, confirming true bloodstream infection. The patient had no conventional risk factors. Antifungal susceptibility testing demonstrated high susceptibility to amphotericin B, voriconazole, and caspofungin, whereas fluconazole showed reduced susceptibility. Due to severe hepatic and renal dysfunction, liposomal amphotericin B was preferred, resulting in rapid clinical improvement and clearance of fungemia. Repeat blood cultures showed no growth, and the patient recovered. A review of the literature identified only 14 previously reported cases of community-acquired K. ohmeri fungemia, most of which occurred in patients with identifiable host risk factors or structural disease. This case presents one of the few reports of primary community-acquired K. ohmeri fungemia in an immunocompetent individual and, to our knowledge, shows the first reported association with severe leptospirosis. K. ohmeri should be considered a potential cause of community-acquired fungemia even in immunocompetent hosts. Accurate species identification, repeated blood culture confirmation, and timely antifungal therapy are critical for favourable outcomes. This case expands the clinical spectrum of K. ohmeri infection and suggests that severe leptospirosis may be a possible predisposing condition.