Ijiri Atsuhiro, Terayama Takero, Sugiura Hiroaki, Kaneko Mayuko, Seno Soichiro, Kiriu Nobuaki, Kato Hiroshi, Sekine Yasumasa, Shinmoto Hiroshi, Kiyozumi Tetsuro
Department of Traumatology and Critical Care Medicine, National Defense Medical College, 3-2 Namiki, Saitama, 359-8513, Japan.
Department of Emergency, Self-Defense Forces Central Hospital, Ikeziri 1-2-24, Setagaya, Tokyo, 154-0001, Japan.
Radiol Case Rep. 2023 Jul 25;18(10):3467-3470. doi: 10.1016/j.radcr.2023.07.017. eCollection 2023 Oct.
Invasive candidiasis is rare but is associated with high mortality in immunocompromised or critically ill patients. Here, we present a case of a 55-year-old man with untreated diabetes who was diagnosed with coronavirus disease 2019 and subsequently developed invasive candidiasis. The patient presented with fever, tachycardia, and tachypnea. Chest computed tomography revealed multiple consolidations mainly distributed around the bronchovascular bundles with bronchiectatic cavity formation, which initially raised suspicion for invasive pulmonary aspergillosis. However, subsequent testing confirmed infection; hence, we changed the antifungal agents effective for invasive candidiasis. This improved the patient's respiratory status, and he was then successfully weaned from mechanical ventilation. This case report highlights the importance of considering invasive candidiasis in the differential diagnosis of patients with bronchiectatic cavities on chest computed tomography, particularly in immunocompromised or critically ill patients with risk factors for invasive candidiasis.
侵袭性念珠菌病较为罕见，但在免疫功能低下或危重症患者中与高死亡率相关。在此，我们报告一例55岁未治疗糖尿病男性患者，其被诊断为2019冠状病毒病，随后发生侵袭性念珠菌病。患者表现为发热、心动过速和呼吸急促。胸部计算机断层扫描显示多个实变灶，主要分布在支气管血管束周围，并形成支气管扩张性空洞，最初怀疑为侵袭性肺曲霉病。然而，随后的检测确诊为念珠菌感染；因此，我们更换了对侵袭性念珠菌病有效的抗真菌药物。这改善了患者的呼吸状况，随后他成功脱机。本病例报告强调了在胸部计算机断层扫描显示支气管扩张性空洞的患者，尤其是有侵袭性念珠菌病危险因素的免疫功能低下或危重症患者的鉴别诊断中考虑侵袭性念珠菌病的重要性。
