Candida Glabrata and Candida Tropicalis in an Immunocompetent Patient

A Case Report

Leslie Hamilton, Nicholas R. Lockhart, Michael R. Crain

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To report a case of Candida glabrata and tropicalis pneumonia in an immunocompetent patient. Case Summary: A 72-yearold male was transferred from an outside institution due to worsening respiratory status, acute kidney injury secondary to intravenous contrast media, sepsis, and pneumonia with fever and leukocytosis. Upon admission, he was initiated on treatment for hospital-acquired pneumonia, but was also concomitantly tested for many other opportunistic infections due to his recent month-long trip to Ecuador where he participated in a tribal treatment for neuropathy that involved direct exposure to dead guinea pigs. With completion of cultures and bronchoalveolar lavage, C. glabrata was identified in the blood culture and C. glabrata and C. tropicalis in the bronchoalveolar lavage specimen. One month later, he was admitted due to recurrent pneumonia. The patient unfortunately expired during the second admission, due to complications from chronic respiratory pulmonary disease and pneumonia. Discussion: Initially, this patient was treated for hospital-acquired pneumonia, but due to a recent trip to Ecuador, it was soon discovered that this patient had developed an invasive Candida pneumonia. His pulmonary biopsies showed growth of invasive C. glabrata and C. tropicalis, while his blood culture showed C. glabrata. Candida-related lower respiratory tract infections are exceptionally rare in immunocompetent patients and require histopathologic evidence to confirm the diagnosis. A second blood culture showed that the C. glabrata was still present and the patient had worsening leukocytosis, so micafungin was added to his antimicrobial therapy. Conclusion: It is understood that pneumonia is rarely caused by Candida species in patients who are admitted to the hospital. However, health care professionals should be aware that Candida pneumonia should be suspected as part of the differential diagnosis even in immunocompetent patients, particularly if they have recently traveled outside the United States.

Original languageEnglish (US)
Pages (from-to)284-287
Number of pages4
JournalJournal of Pharmacy Practice
Volume28
Issue number3
DOIs
StatePublished - Jun 3 2015

Fingerprint

Candida tropicalis
Candida glabrata
Pneumonia
Candida
Ecuador
Leukocytosis
Bronchoalveolar Lavage
Opportunistic Infections
Acute Kidney Injury
Respiratory Tract Infections
Contrast Media
Lung Diseases
Sepsis
Guinea Pigs
Differential Diagnosis
Fever
Therapeutics
Delivery of Health Care
Biopsy
Lung

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Candida Glabrata and Candida Tropicalis in an Immunocompetent Patient : A Case Report. / Hamilton, Leslie; Lockhart, Nicholas R.; Crain, Michael R.

In: Journal of Pharmacy Practice, Vol. 28, No. 3, 03.06.2015, p. 284-287.

Research output: Contribution to journalArticle

Hamilton, Leslie ; Lockhart, Nicholas R. ; Crain, Michael R. / Candida Glabrata and Candida Tropicalis in an Immunocompetent Patient : A Case Report. In: Journal of Pharmacy Practice. 2015 ; Vol. 28, No. 3. pp. 284-287.
@article{8129ca9d7fed49b1b0396413f4259526,
title = "Candida Glabrata and Candida Tropicalis in an Immunocompetent Patient: A Case Report",
abstract = "Objective: To report a case of Candida glabrata and tropicalis pneumonia in an immunocompetent patient. Case Summary: A 72-yearold male was transferred from an outside institution due to worsening respiratory status, acute kidney injury secondary to intravenous contrast media, sepsis, and pneumonia with fever and leukocytosis. Upon admission, he was initiated on treatment for hospital-acquired pneumonia, but was also concomitantly tested for many other opportunistic infections due to his recent month-long trip to Ecuador where he participated in a tribal treatment for neuropathy that involved direct exposure to dead guinea pigs. With completion of cultures and bronchoalveolar lavage, C. glabrata was identified in the blood culture and C. glabrata and C. tropicalis in the bronchoalveolar lavage specimen. One month later, he was admitted due to recurrent pneumonia. The patient unfortunately expired during the second admission, due to complications from chronic respiratory pulmonary disease and pneumonia. Discussion: Initially, this patient was treated for hospital-acquired pneumonia, but due to a recent trip to Ecuador, it was soon discovered that this patient had developed an invasive Candida pneumonia. His pulmonary biopsies showed growth of invasive C. glabrata and C. tropicalis, while his blood culture showed C. glabrata. Candida-related lower respiratory tract infections are exceptionally rare in immunocompetent patients and require histopathologic evidence to confirm the diagnosis. A second blood culture showed that the C. glabrata was still present and the patient had worsening leukocytosis, so micafungin was added to his antimicrobial therapy. Conclusion: It is understood that pneumonia is rarely caused by Candida species in patients who are admitted to the hospital. However, health care professionals should be aware that Candida pneumonia should be suspected as part of the differential diagnosis even in immunocompetent patients, particularly if they have recently traveled outside the United States.",
author = "Leslie Hamilton and Lockhart, {Nicholas R.} and Crain, {Michael R.}",
year = "2015",
month = "6",
day = "3",
doi = "10.1177/0897190014568387",
language = "English (US)",
volume = "28",
pages = "284--287",
journal = "Journal of Pharmacy Practice",
issn = "0897-1900",
publisher = "SAGE Publications Inc.",
number = "3",

}

TY - JOUR

T1 - Candida Glabrata and Candida Tropicalis in an Immunocompetent Patient

T2 - A Case Report

AU - Hamilton, Leslie

AU - Lockhart, Nicholas R.

AU - Crain, Michael R.

PY - 2015/6/3

Y1 - 2015/6/3

N2 - Objective: To report a case of Candida glabrata and tropicalis pneumonia in an immunocompetent patient. Case Summary: A 72-yearold male was transferred from an outside institution due to worsening respiratory status, acute kidney injury secondary to intravenous contrast media, sepsis, and pneumonia with fever and leukocytosis. Upon admission, he was initiated on treatment for hospital-acquired pneumonia, but was also concomitantly tested for many other opportunistic infections due to his recent month-long trip to Ecuador where he participated in a tribal treatment for neuropathy that involved direct exposure to dead guinea pigs. With completion of cultures and bronchoalveolar lavage, C. glabrata was identified in the blood culture and C. glabrata and C. tropicalis in the bronchoalveolar lavage specimen. One month later, he was admitted due to recurrent pneumonia. The patient unfortunately expired during the second admission, due to complications from chronic respiratory pulmonary disease and pneumonia. Discussion: Initially, this patient was treated for hospital-acquired pneumonia, but due to a recent trip to Ecuador, it was soon discovered that this patient had developed an invasive Candida pneumonia. His pulmonary biopsies showed growth of invasive C. glabrata and C. tropicalis, while his blood culture showed C. glabrata. Candida-related lower respiratory tract infections are exceptionally rare in immunocompetent patients and require histopathologic evidence to confirm the diagnosis. A second blood culture showed that the C. glabrata was still present and the patient had worsening leukocytosis, so micafungin was added to his antimicrobial therapy. Conclusion: It is understood that pneumonia is rarely caused by Candida species in patients who are admitted to the hospital. However, health care professionals should be aware that Candida pneumonia should be suspected as part of the differential diagnosis even in immunocompetent patients, particularly if they have recently traveled outside the United States.

AB - Objective: To report a case of Candida glabrata and tropicalis pneumonia in an immunocompetent patient. Case Summary: A 72-yearold male was transferred from an outside institution due to worsening respiratory status, acute kidney injury secondary to intravenous contrast media, sepsis, and pneumonia with fever and leukocytosis. Upon admission, he was initiated on treatment for hospital-acquired pneumonia, but was also concomitantly tested for many other opportunistic infections due to his recent month-long trip to Ecuador where he participated in a tribal treatment for neuropathy that involved direct exposure to dead guinea pigs. With completion of cultures and bronchoalveolar lavage, C. glabrata was identified in the blood culture and C. glabrata and C. tropicalis in the bronchoalveolar lavage specimen. One month later, he was admitted due to recurrent pneumonia. The patient unfortunately expired during the second admission, due to complications from chronic respiratory pulmonary disease and pneumonia. Discussion: Initially, this patient was treated for hospital-acquired pneumonia, but due to a recent trip to Ecuador, it was soon discovered that this patient had developed an invasive Candida pneumonia. His pulmonary biopsies showed growth of invasive C. glabrata and C. tropicalis, while his blood culture showed C. glabrata. Candida-related lower respiratory tract infections are exceptionally rare in immunocompetent patients and require histopathologic evidence to confirm the diagnosis. A second blood culture showed that the C. glabrata was still present and the patient had worsening leukocytosis, so micafungin was added to his antimicrobial therapy. Conclusion: It is understood that pneumonia is rarely caused by Candida species in patients who are admitted to the hospital. However, health care professionals should be aware that Candida pneumonia should be suspected as part of the differential diagnosis even in immunocompetent patients, particularly if they have recently traveled outside the United States.

UR - http://www.scopus.com/inward/record.url?scp=84930452009&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930452009&partnerID=8YFLogxK

U2 - 10.1177/0897190014568387

DO - 10.1177/0897190014568387

M3 - Article

VL - 28

SP - 284

EP - 287

JO - Journal of Pharmacy Practice

JF - Journal of Pharmacy Practice

SN - 0897-1900

IS - 3

ER -