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Case Report
A rare case of Candida parapsilosis pneumonia in an immunocompetent patient
1 Resident PGY1, Internal Medicine, UCF/North Florida Regional Medical Center, HCA Florida North Florida Hospital, Graduate Medical Education, Gainesville, Florida, USA
2 Resident PGY3, Internal Medicine, UCF/North Florida Regional Medical Center, HCA Florida North Florida Hospital, Graduate Medical Education, Gainesville, Florida, USA
3 Transitional Year Program Director, Transitional Year, UCF/North Florida Regional Medical Center, HCA Florida North Florida Hospital, Graduate Medical Education, Gainesville, Florida, USA
4 Internal Medicine Program Director, UCF/North Florida Regional Medical Center, HCA Florida North Florida Hospital, Graduate Medical Education, Gainesville, Florida, USA
Address correspondence to:
Raiya Habib
Gainesville, Florida,
USA
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Article ID: 101399Z01RH2023
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How to cite this article
Habib R, Ismail Z, Nanajian A, Calestino M, Bray C. A rare case of Candida parapsilosis pneumonia in an immunocompetent patient. Int J Case Rep Images 2023;14(2):1–5.ABSTRACT
Introduction: The presence of fungus in an immunocompetent host is usually disregarded as a mere contaminant, as it can be a commensal organism of the skin, gastrointestinal, urogenital, and respiratory tract. Hence, its growth in cultures has to be interpreted within a clinical context. This case illustrates the challenges experienced when diagnosing Candida parapsilosis necrotizing pneumonia, and the importance for considering candida pneumonia as a differential diagnosis for an immunocompetent patient. After a thorough literature review, we would like to present the first case report of C. parapsilosis causing necrotizing pneumonia in an immunocompetent patient.
Case Report: We present a case involving a middle-aged smoking male who presented with respiratory and metabolic abnormalities and was found to have necrotizing pneumonia. He was managed for severe sepsis with lactic acidosis, respiratory failure, and severe acute kidney injury (AKI), which improved with broad spectrum antibiotics and fluids. These conditions improved; however, his respiratory distress did not despite a prolonged course of antibiotics. This led to a workup for other causes of necrotizing pneumonia, after which cultures revealed the growth of C. parapsilosis. He was then started on antifungals and subsequently improved.
Conclusion: Candida necrotizing pneumonia is a rare disease for an immune-competent individual; however, chronic lung damage in the setting of a smoking history may make individuals more susceptible. This case illustrates the challenges associated when dealing with such a case, and it is the team’s hope that publishing this case will add to awareness. Additionally, this can contribute to improved antibiotic stewardship and earlier diagnosis which will hopefully lead to a shorter hospital stay and improved morbidity and mortality.
Keywords: Candida pneumonia, Immunocompetent, Necrotizing pneumonia
SUPPORTING INFORMATION
Acknowledgments
The authors would sincerely like to address their gratitude to all the doctors who made this case report possible.
Author ContributionsRaiya Habib - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Zeeshan Ismail - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Anthony Nanajian - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Matthew Calestino - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Christopher Bray - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Raiya Habib 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.
