Ali Y, Mousa A, Mohamed H, Ibrahim M, Naveed M, Alsamawi M
Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.
Medical education department, Hamad Medical Corporation, Doha, Qatar.
IDCases. 2023 Jul 5;33:e01840. doi: 10.1016/j.idcr.2023.e01840. eCollection 2023.
Candida is a frequent respiratory tract colonizer. True candida pneumonia is rare and seen with predominance in immunosuppressed patients. Our aim is to document a previously unreported case of Candida pneumonia in a young and immunocompetent patient, highlighting, an unusual pathological manifestation of this infection in immunocompetent individuals.
We report a previously healthy young lady who remained symptomatic with fever, cough and shortness of breath for three weeks duration despite treatment with extensive antibiotics regimen for community acquired pneumonia. She was eventually treated as a probable, rare case of candida pneumonia. The patient demonstrated a dramatic response to single antifungal treatment both clinically and biochemically within the first 24hrs of treatment. Candida albican was isolated on repetitive cultures form the sputum and bronchoalevolar lavage samples. The patient had negative blood cultures. Her HRCT scan revealed bilateral basal air space opacities with peri bronchovascular distribution and centrilobular nodules with branching pattern suggestive of tree in bud predominantly in lower lobes. Her endobronchial biopsies was mostly unremarkable apart from rare non-necrotizing granuloma.
can rarely cause clinically significant pneumonia in immunocompetent patients and should be considered in the differential diagnosis of granulomatous lung disease.
念珠菌是呼吸道常见的定植菌。真正的念珠菌肺炎很少见，主要见于免疫抑制患者。我们的目的是记录一例此前未报道的年轻免疫功能正常患者的念珠菌肺炎病例，突出这种感染在免疫功能正常个体中不寻常的病理表现。
我们报告一名既往健康的年轻女性，尽管接受了针对社区获得性肺炎的广泛抗生素治疗，但仍持续发热、咳嗽和气短症状达三周。她最终被当作可能的罕见念珠菌肺炎病例进行治疗。患者在治疗的头24小时内，临床和生化指标对单一抗真菌治疗均表现出显著反应。从痰液和支气管肺泡灌洗样本的重复培养中分离出白色念珠菌。患者血培养结果为阴性。她的高分辨率CT扫描显示双侧基底段气腔实变，呈支气管血管周围分布，伴有小叶中心结节，呈分支状，提示以两下肺为主的树芽征。除了罕见的非坏死性肉芽肿外，她的支气管活检大多无明显异常。
念珠菌在免疫功能正常的患者中很少引起具有临床意义的肺炎，在肉芽肿性肺病的鉴别诊断中应予以考虑。
