CASE REPORT ON CANDIDA PNEUMONIA: A RARE INFECTION DUE TO CANDIDA KRUSEI

Prathvi M. V., Lijo K. J.*, Meeval Skariah and Dr. Sonia Elizabeth Ninan

ABSTRACT

Fungal infections caused due to candida species now recognized as a high cause of morbidity and mortality in hospitalized patients. They are capable of causing infections in both immuno-compromised and immuno-competant individuals. But the incidence of infections is more in immunocompromised patients. According to the infectious disease society of America clinical practice guideline, candida is frequently isolated from patients who are in intensive care units and are intubated. Candida pneumonia is a rare infection of the lungs, with the majority of cases arising as a result of the Candida organism spreading. The specificity of the pathogens and the slow-moving course of pneumomycosis pose significant challenges for proper diagnosis and delay the timely start of treatment, aggravating inflammatory changes. It is understood that hospitalized individuals rarely develop pneumonia from a Candida species. However even in patients who are immunocompetent, health care practitioners should be aware that Candida pneumonia should be suspected as part of the differential diagnosis. A 53 year old gentleman presented with complaints of a productive cough with whitish sputum of non foul smell and shortness of breath (insidious onset) for 2 days. His chest X-ray revealed pulmonary edema with elevated inflammatory markers suspecting sepsis. Accordingly, the treatment was initiated. Video bronchoscopy was performed, revealing mucoid secretions in the right ML/LL segments. He was kept on intermittent NIV(1:2) due to persistent tachycardia and tachypnea and repeated chest X-rays that revealed pneumonia. On day 8, BAL culture yielded C.krusei, revealing a rising trend in blood counts. Treatment initiated with T. Voriconazole 200 mg which is sensitive to C. krusei along with T. Doxycycline 100mg and Inj. Meropenem 1gm. By day 15, the patient was feeling symptomatically better. In conclusion, the diagnosis of candida pneumonia should be strongly considered in the presence of growth of candida from a sputum culture and immediate treatment should be initiated according to the sensitivity pattern for the early prevention, to prevent further complications and to improve patient condition.

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