Autopsy and Case Reports
https://www.autopsyandcasereports.org/article/doi/10.4322/acr.2023.443
Autopsy and Case Reports
Autopsy Case Report

Invasive Candida pneumonia, in association with Candida esophagitis and gastritis, in a presumably immunocompetent patient

Devon Jackson; Lamarque Coke; Kamilah Fernandez; Kathriel Brister

Downloads: 1
Views: 507

Abstract

Candida pneumonia remains a difficult diagnosis and is most common in immunocompromised individuals. It has been rarely reported in immunocompetent individuals. We present a case of unsuspected Candida pneumonia associated with Candida esophagitis and gastritis discovered on postmortem examination in a presumably immunocompetent patient. The patient was a 71-year-old male who presented with chest pain and was subsequently found to have a myocardial infarction treated with angioplasty and drug-eluting stent placement. The patient’s recovery was complicated by pneumonia refractory to antibiotics, and he went on to experience acute hypoxic respiratory failure, sepsis, disseminated intravascular coagulation (DIC), and ultimately expired. Autopsy revealed evidence of myocardial infarction as well as unsuspected Candida albicans pneumonia, esophagitis, and gastritis. Our case highlights how a presumably immunocompetent individual can develop this infection and how Candida esophagitis and Candida gastritis can be seen in association with Candida pneumonia. Due to the difficulty in diagnosing Candida pneumonia antemortem, autopsies provide a key opportunity to better understand these cases and the factors that may contribute to their development.

Keywords

Candida, pneumonia, esophagitis, gastritis

References

1 Kobayashi T, Miyazaki Y, Yanagihara K, et al. A probable case of aspiration pneumonia caused by Candida glabrata in a non-neutropenic patient with candidemia. Intern Med. 2005;44(11):1191-4. http://dx.doi.org/10.2169/internalmedicine.44.1191. PMid:16357460.

2 Meersseman W, Lagrou K, Spriet I, et al. Significance of the isolation of Candida species from airway samples in critically ill patients: a prospective, autopsy study. Intensive Care Med. 2009;35(9):1526-31. http://dx.doi.org/10.1007/s00134-009-1482-8. PMid:19357832.

3 Dermawan JKT, Ghosh S, Keating MK, Gopalakrishna KV, Mukhopadhyay S. Candida pneumonia with severe clinical course, recovery with antifungal therapy and unusual pathologic findings: a case report. Medicine (Baltimore). 2018;97(2):e9650. http://dx.doi.org/10.1097/MD.0000000000009650. PMid:29480879.

4 Meena DS, Kumar D. Candida pneumonia: an innocent bystander or a silent killer? Med Princ Pract. 2022;31(1):98-102. http://dx.doi.org/10.1159/000520111. PMid:34638123.

5 Moss BJ, Musher DM. Candida species in community-acquired pneumonia in patients with chronic aspiration. Pneumonia. 2021;13(1):12. http://dx.doi.org/10.1186/s41479-021-00090-x. PMid:34218811.

6 Schnabel RM, Linssen CF, Guion N, van Mook WN, Bergmans DC. Candida pneumonia in intensive care unit? Open Forum Infect Dis. 2014;1(1):ofu026. http://dx.doi.org/10.1093/ofid/ofu026. PMid:25734099.

7 Hung W, Yang K. Candida pneumonia diagnosed by bronchoalveolar lavage: a case report. Thorac Med. 2017;32(6):266-71.

8 Haron E, Vartivarian S, Anaissie E, Dekmezian R, Bodey GP. Primary Candida pneumonia. Experience at a large cancer center and review of the literature. Medicine (Baltimore). 1993;72(3):137-42. http://dx.doi.org/10.1097/00005792-199305000-00001. PMid:8502166.

9 Leslie KO, Wick MR. Practical pulmonary pathology: a diagnostic approach. 2nd ed. Philadelphia, PA: Saunders Elsevier; 2011.

10 Barkauskas CE, Perfect JR. Candida pneumonia: what we know and what we don’t. Curr Fungal Infect Rep. 2009;3(1):21-31. http://dx.doi.org/10.1007/s12281-009-0004-z.

11 Thorn JL, Gilchrist KB, Sobonya RE, Gaur NK, Lipke PN, Klotz SA. Postmortem candidaemia: marker of disseminated disease. J Clin Pathol. 2010;63(4):337-40. http://dx.doi.org/10.1136/jcp.2009.070607. PMid:19939858.

12 Petty LA, Gallan AJ, Detrick JA, Ridgway JP, Mueller J, Pisano J. Candida dubliniensis pneumonia: a case report and review of literature. Mycopathologia. 2016;181(9-10):765-8. http://dx.doi.org/10.1007/s11046-016-0032-5. PMid:27342836.

13 Talapko J, Juzbašić M, Matijević T, et al. Candida albicans-the virulence factors and clinical manifestations of infection. J Fungi (Basel). 2021;7(2):79. http://dx.doi.org/10.3390/jof7020079. PMid:33499276.

14 Gock M, Schäfer M, Perren A, Demartines N, Clavien PA. Fatal esophageal perforation caused by invasive candidiasis. Ann Thorac Surg. 2005;80(3):1120-2. http://dx.doi.org/10.1016/j.athoracsur.2004.02.147. PMid:16122508.

15 Rajablou M, Ganz RA, Batts KP. Candida infection presenting as multiple ulcerated masses. Gastrointest Endosc. 2007;65(1):164-6. http://dx.doi.org/10.1016/j.gie.2006.05.024. PMid:17137861.

16 Rai P, Chakraborty SB. Giant fungal gastric ulcer in an immunocompetent individual. Saudi J Gastroenterol. 2012;18(4):282-4. http://dx.doi.org/10.4103/1319-3767.98438. PMid:22824773.

17 Worthington M. Fatal candida pneumonia in a non-immunosuppressed host. J Infect. 1983;7(2):159-61. http://dx.doi.org/10.1016/S0163-4453(83)90674-6. PMid:6644084.

18 Kontoyiannis DP, Reddy BT, Torres HA, et al. Pulmonary candidiasis in patients with cancer: an autopsy study. Clin Infect Dis. 2002;34(3):400-3. http://dx.doi.org/10.1086/338404. PMid:11774088.

19 Awwad M, Peysakhovich Y, Bishara J, Kagan I, Issachar A, Eliakim Raz NA. 47-year-old liver and kidney transplant patient with Candida pneumonia. Isr Med Assoc J. 2022;24(11):781-2. PMid:36436052.
 


Submitted date:
06/01/2023

Accepted date:
06/27/2023

Publication date:
08/07/2023

64d0e2b6a95395216d2c3f04 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections