Pneumonia due to Candida krusei

Abstract

A case of post-transplantation pneumonia due to Candida krusei is reported. A 42-year-old man was admitted 28 days after heart transplantation with cough, pleuritic pain and fever. A chest computed tomograph showed multiple alveolar infiltrates bilaterally. He received broad-spectrum antibiotics, fluconazole for oral candidiasis, and cotrimoxazole for possible Pneumocystis carinii. A short-lived period of improvement was followed by respiratory failure. Cultures of bronchial washings grew C. krusei and C. albicans. The infection was documented by histology and culture obtained by transthoracic aspiration. Treatment with amphotericin B was initiated, but the patient died. Histology and culture of a pulmonary specimen, obtained immediately post mortem, further documented the infection with C. krusei.

Severe pneumonia due to infection with Candida krusei in a case of suspected Middle East respiratory syndrome: A case report and literature review

“…Candida invasive infection usually affects immunocompromised patients or those receiving broad-spectrum antibiotic therapy. As reported in previous studies, solid organ transplant (3,26), hematological malignancies (27), esophageal perforation (28) and diabetes (29) appear to facilitate C. krusei pneumonia and empyema (11). Similarly, the patient of the current study presented a long-term medical history of diabetes, coronary heart disease and chronic diabetic kidney insufficiency, but did not receive administration of hormone therapy and antibiotics.…”

“…Pneumonia due to Candida infection is rare and frequently associated with a fatal outcome, with a mortality rate up to 70% (1)(2)(3). It occurs predominantly in immunocompromised patients, or patients receiving broad-spectrum antibiotic therapy (4).…”

“…However, only a limited number of cases have since been reported in the English literature (8). In search of the PubMed database (http://www.ncbi.nlm.nih.gov/pubmed accessed 14 May, 2009), 91 cases of Candida pneumonia confirmed by histopathology (1)(2)(3)(8)(9)(10) were identified. In particular, Candida krusei (C. krusei) infection is less frequently encountered in clinical mycology compared with other species of Candida pathogens, with the first case of C. krusei infection reported in 2002 (3,11).…”

Aspiration pneumonia: With special reference to pathological and epidemiological aspects, a review of the literature

“…albicans is the most common Candida pathogen not only in systemic but also in Candidal pneumonia [60][61][62][63]. Candida glabrata accounts for up to 20% of Candidal pneumonia [63] occurs almost exclusively in immunocompromised patients [64]. However, some epidemiologic studies have described that C. glabrata is a pathogen of lower respiratory infections [61][62][63].…”

Cardiac Candida krusei infection

“…Majority of the reported cases with hematogenous spread have died[2] Basic antifungal treatment such as Amphotericin B administration is usually unsuccessful. [3] In the case of cardiac infection, cardiac ischemia leading to death has also been reported. [2] Intravenous Caspofungin therapy has been reported to be the only successful treatment for this condition.…”