<i>Candida</i>Empyema Thoracis at a Hospital in Taiwan

Lin, Hailong; Chao, Chien‐Ming; Lin, Wei−Ting; Lai, Chih‐Cheng

doi:10.1089/sur.2013.033

Cited by 5 publications

(3 citation statements)

References 14 publications

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“… 3 C. albicans (n = 4) was also found to be a common cause of fungal empyema in a case series of eight patients from Taiwan and overall in hospital mortality reported was 62.5%. 13 In another study from Taiwan, the mortality rate was 61.9% with C. albicans being the commonest pathogen (76.5%). 11 We found a decreased mortality rate compared to these studies, which might be due to intervention such as VATS decortication performed in 53.8% and antifungal use in 80.8% of patients.…”

Section: Discussionmentioning

confidence: 96%

Fungal empyema thoracis, a rare but an emerging entity: a retrospective case series from Pakistan

Iqbal,

Ali,

Zahid

et al. 2023

Therapeutic Advances in Infection

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Background and objective: Fungal empyema is a rare entity which is associated with high mortality. It is mostly seen in immune-compromised hosts. However, there is limited data available on fungal empyema from developing countries regarding risk factors, treatment, and outcome. This study was conducted to determine the risk factors, clinical features, treatment, and outcome of fungal empyema. Methods: A retrospective observational study was performed on proven fungal empyema cases, admitted at Aga Khan University Hospital, Karachi, Pakistan during January 2018 to May 2021. We excluded all those patients with polymicrobial bacterial and fungal empyema or with negative pleural fluid cultures. A preformed questionnaire was filled out for each case. Results: A total of 26 patients were diagnosed with fungal empyema with a mean age of 43.6 ± 20.3 years. Of these, 16 (61.5%) patients were male. Diabetes mellitus was the most frequent comorbidity ( n = 11, 42.3%), followed by hypertension ( n = 9, 34.6%), malignancy ( n = 6, 23.1%), and asthma ( n = 1, 3.8%). Ten (38.5%) patients had multiple comorbidities. Candida spp. was isolated in 21 (80.8%) patients and Aspergillus spp. in 7 (26.9%) patients. Fusarium spp. was isolated from one (3.9%) patient. Video-assisted thoracoscopy surgery was done in 14 (53.8%) patients and 12 (46.1%) patients were managed with tube thoracostomy. Twenty-one (80.8%) patients received antifungal agents. Overall, in-hospital mortality was 38.5% ( n = 10) and all patients developed respiratory failure. Clinical improvement was seen in 16 (61.5%) patients. Conclusion: Our data suggest that fungal empyema has a poor outcome as almost one-third of our patients died. Early diagnosis and intervention can improve outcome.

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Section: Discussionmentioning

confidence: 96%

Fungal empyema thoracis, a rare but an emerging entity: a retrospective case series from Pakistan

Iqbal,

Ali,

Zahid

et al. 2023

Therapeutic Advances in Infection

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“…ere is an increased risk of morbidity and mortality in immunocompromised patients particularly those with respiratory failure [5], hence early identification, initiation of antifungal therapy, drainage, and surgical repair is necessary to improve overall morbidity and mortality. Multiple studies have identified Candida albicans as the most common isolate [1,6]. Because Candida empyema is rare, there are no randomized controlled trials to guide medical or surgical management of these cases.…”

Section: Discussionmentioning

confidence: 99%

Candida Empyema as a Red Flag for Esophageal Rupture: A Case Report and Literature Review

Ali

Abate

2020

Case Reports in Infectious Diseases

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Background. Candida empyema is a rare entity with an extremely high mortality rate.We present a case of multi species Candida empyema in an immunocompetent female patient with Boerhaave syndrome secondary to retching and vomiting after heroin withdrawal. This case highlights an unusual presentation of a common infection but stresses on the fact that a high index of suspicion is necessary for early identification, prompt initiation of antifungal therapy, and drainage with surgical repair to improve overall survival and outcomes.

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“…A retrospective study conducted in Australia indicated that FET was commonly seen in postoperative immunosuppressed patients with the incidence of only 7.0% in the ET patients [7]. However, a high mortality was observed in patients with FET, for example, one study in American showed a 6-week mortality of 34%, and another two Taiwan studies reported the mortality was up to 61.9%-73.0% [8][9][10]. Pneumonia, surgery and gastrointestinal tract rupture were reported to be the most common causes of FET [8].…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and related factors of fungal empyema thoracis

Zhong¹,

Qian²,

Hou³

et al. 2020

Preprint

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ObjectData on the characteristics and related factors of fungal empyema thoracis (FET) are limited. Our aim is to investigate the clinical characteristics and related factors of FET.MethodsWe conducted a retrospective study of patients with positive culture from pleural effusion who were admitted to the First Affiliated Hospital of Soochow University between January 2007 and January 2018. The clinical and laboratory characteristics of all study participants were collected. Logistic regression models were used to assess the related factors of FET.ResultsThere were 30 patients diagnosed with FET. The median age of patients with FET was 62.7 years old and 24 (80.0%) were male. The most frequent pathogens of FET were Candida albicans (55.9%). Diabetes mellitus (23.3% vs. 7.9%, P = 0.019) and upper gastrointestinal tract perforation or rupture (20.0% vs. 2.1%, P < 0.001) were associated with increased risk of FET. The adjusted odds ratios (95% confident interval) were 3.11 (1.02–9.56) for diabetes mellitus and 12.71 (3.47–46.55) for upper gastrointestinal tract perforation or rupture. There were 10 deaths (33.3%) among FET patients after one-year of follow-up.ConclusionsDiabetes mellitus and upper gastrointestinal tract perforation or rupture were associated with increased risk of FET.

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CandidaEmpyema Thoracis at a Hospital in Taiwan

Abstract: Although Candida empyema thoracis is encountered rarely, it can develop in immunocompromised patients and can be associated with a high mortality rate.

Cited by 5 publications

References 14 publications

Fungal empyema thoracis, a rare but an emerging entity: a retrospective case series from Pakistan

Fungal empyema thoracis, a rare but an emerging entity: a retrospective case series from Pakistan

Candida Empyema as a Red Flag for Esophageal Rupture: A Case Report and Literature Review

Clinical characteristics and related factors of fungal empyema thoracis

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