Case Report


Unusual invasive candidiasis by Candida glabrata in a patient with systemic lupus erythematosus: Case report

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1 Graduate Program in Health Sciences, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil; Department of Physiotherapy Uni Cesumar, Maringá, PR, Brazil

2 Graduate Programa in Health Sciences, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil

3 Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringa, Avenida Colombo 5790, 87020-900 Maringa, PR, Brazil

Address correspondence to:

Terezinha Inez Estivalet Svidzinski

Universidade Estadual de Maringá, Av. Colombo 5790, Bloco T20, Sala 203, CEP 87020-900, Maringá, Paraná,

Brazil

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Article ID: 101233Z01EF2021

doi: 10.5348/101233Z01EF2021CR

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How to cite this article

Ferreira EG, Jarros IC, Veiga FF, Corrêa JL, Pedroso RB, Negri M, Svidzinski TIE. Unusual invasive candidiasis by Candida glabrata in a patient with systemic lupus erythematosus: Case report. Int J Case Rep Images 2021;12:101233Z01EF2021.

ABSTRACT


Introduction: Systemic Candida glabrata infections have increased dramatically over the years. However, few studies have associated them with autoimmune diseases, such as systemic lupus erythematosus.

Case Report: We report the case of a patient with systemic lupus erythematosus, admitted with gastrointestinal complaints and oral bleeding. She had an unfavorable clinical evolution with renal failure, requiring hemodialysis and invasive ventilatory support, and fungal septic shock followed by death. The culture grown on the central venous catheter was negative for fungi, but the yeast C. glabrata was observed in all other cultures, as regarding a fungal infection (urine and blood) as for monitoring colonization (tongue and tracheal secretion). The high similarity between the isolated yeasts strongly suggested a common origin of the colonizing yeasts of the oral cavity and respiratory tract, as well as those involved in the infection.

Conclusion: This finding confirms that nosocomial infection by C. glabrata is a reality today and it should not be neglected; furthermore, the management of patients with systemic lupus erythematosus should be rethought because the imbalance of the organic response makes patients susceptible to infections, such as invasive candidiasis.

Keywords: Candidemia, Candida glabrata, Sepse, Systemic lupus erythematosus, Tongue coating

SUPPORTING INFORMATION


Acknowledgments

This study was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Conselho Nacional de Desenvolvimen to Científico e Tecnológico (CNPq), Fundação de Amparo à Pesquisa do Estado do Paraná (Fundação Araucária).

Author Contributions

Elenice Gomes Ferreira - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Isabele Carrilho Jarros - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published

Flávia Franco Veiga - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published

Jakeline Luiz Corrêa - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published

Raíssa Bocchi Pedroso - Acquisition of data, Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Melyssa Negri - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Terezinha Inez Estivalet Svidzinski - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Guarantor of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2021 Elenice Gomes Ferreira et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.