Invasive infections caused by Malassezia spp: A comprehensive review of cases from 1979 to 2024

Malassezia are lipid-dependent commensal yeasts and an uncommon cause of invasive fungal infection. These are likely underreported due to the specific requirements for Malassezia growth, and therefore poorly understood. This review compiles all cases of invasive Malassezia infection published to date and depicts the main features of these infections. A literature search was conducted using PubMed up to December 2024. 803 records were found, of which 167 cases were analyzed. The review highlights the epidemiology and predisposing factors, with premature newborns, digestive diseases, and lipid supplementation being the main. Further studies are needed to evaluate the usefulness of molecular techniques for detecting Malassezia in blood and tissues. The review suggests a shift in the causative species related to more reliable identification systems. While being the most frequently used antifungal drug, there is little evidence that intravenous amphotericin B is the most appropriate treatment.