Pulmonary Candidiasis in Patients with Cancer: An Autopsy Study

Abstract

For patients who had cancer and autopsy-proven pneumonia, we evaluated whether cultures of respiratory secretions (sputum and/or bronchoalveolar lavage) performed < or =4 weeks before autopsy were a reliable basis for the diagnosis of pulmonary candidiasis. Pulmonary candidiasis was identified at autopsy in 36 patients, but common clinical predictors were insensitive for this diagnosis. For sputum culture, the sensitivity, specificity, and the positive and negative predictive values were 85%, 60%, 42%, and 93%, respectively; for bronchoalveolar lavage culture, these values were 71%, 57%, 29%, and 89%, respectively.

Modern management of respiratory failure due to pulmonary mycoses following allogeneic hematopoietic stem‐cell transplantation

“…These new methods include PCR detection of fungal DNA and a variety of serologic tests such as detection of circulating fungal antigens or antifungal antibodies. For instance, the fungal cell wall component galactomannan has been shown to be a sensitive marker for invasive aspergillosis [20][21][22][23]. These new diagnostic tests may not only be of considerable benefit for high-risk patients who should be screened for fungal infections at regular intervals, but they have also proven to be useful in monitoring the response to antifungal therapy [19].…”

Candida albicans Csy1p Is a Nutrient Sensor Important for Activation of Amino Acid Uptake and Hyphal Morphogenesis

“…Depending on host immunity, infection by this organism can be either superficial or hematogenously disseminated, resulting in life-threatening systemic candidiasis (19,24,27,28,38,44,45). C. albicans undergoes a reversible switch between yeast, pseudohyphal, and hyphal growth in response to various stimuli (36,40).…”

Fatal Community-Acquired Primary <i>Candida</i> Pneumonia in an Alcoholic Patient

“…These may not be readily available in normal clinical practice. Therefore, our understanding of this disease primarily rests on the results of previous autopsy studies (2,4,5), and available data suggest that Candida pneumonia is a rare disorder. In fact, Meersseman et al demonstrated that no single case of Candida pneumonia was found among 232 autopsy cases in the intensive care unit, despite frequent isolation of Candida species from respiratory tract samples (7).…”

“…Candida pneumonia is a rare disorder that is challenging to diagnose, with a definitive diagnosis being based exclusively on histological evidence (1,2). When the disease occurs, the pathogenic mechanism is largely attributed to secondary lung involvement in a systemic infection.…”

“…Therefore, invasive Candida infection limited to the lungs (primary Candida pneumonia) is quite a rare form of the disease (3). To date, autopsy studies of primary Candida pneumonia occurring in cancer patients have attributed the disease to hospital-acquired pneumonia (2,4,5). However, there is still a paucity of literature regarding whether the disease can occur in the community-acquired setting.…”