Detection of human herpesvirus 8 in cervical cells of Chinese women with abnormal papanicolaou smears.

picalis that was resistant to fluconazole, itraconazole, and clotrimazole. Because he had a history of injection drug use, it is possible that he may have been colonized by this strain of Candida for some time and acquired the fungemia from injecting. Although he was not HIV-positive, he may have shared needles or been exposed to someone who was HIV-positive and thus may have become colonized with the resistant C. tropicalis strain. In addition, there are several recent reports describing antifungal cross-resistance among azoles. The majority of the Candida species isolates that have cross-resistance have been recovered from patients with advanced AIDS, low CD4 cell counts, a history of long-term antifungal use, and clinically refractory oropharyngeal and/or esophageal candidiasis [3, 4]. This case is unusual for a variety of reasons. First, community-acquired C. tropicalis fungemia is an extremely uncommon infection, especially when the patient has no underlying risk factors associated with fungal infections. Second, it is uncommon to have fungemia with a non-albicans Candida species that is known to be azole-susceptible and demonstrates fluconazole resistance and high-level resistance to itraconazole and clotrimazole. This observation once again raises questions regarding the incidence, acquisition, and mechanisms of resistance in fungal species causing infection in a patient population with few risk factors. In addition, it is essential to develop molecular techniques that may be used to identify organisms that may be resistant to the antifungals currently in use.