Table 1.
Characteristics of Patients With Presumed Candida Pneumonia, Medical History, and Results of Examinations
Case 1 | Case 2 | Case 3 | Case 4 | Case 5 | |
---|---|---|---|---|---|
Age | 84 | 58 | 74 | 55 | 70 |
Sex | Female | Male | Male | Male | Male |
Admission | Respiratory insufficiency, general malaise, watery diarrhea, loss of appetite, vomiting |
General malaise | Bacterial meningitis | Respiratory insufficiency | Myocardial infarction |
Medical history | Radical abdominal hysterectomy for endometrial carcinoma | Myelodysplastic syndrome, allogenic stem cell transplantation |
Nonactive tuberculosis, urothelial carcinoma |
Resection of brain metastasis, poorly differentiated adenocarcinoma |
Coronary artery disease |
Complicating factors | Zenker's diverticel, malnourished, nicotine abuse |
Graft-versus-host disease, prednisolone and cyclosporine use |
Perforated diverticulitis, dexamethasone medication |
Necrotizing pancreatitis, dexamethasone medication |
Aspiration |
Radiology | X-ray: bilateral micronodular infiltrates | X-ray: infiltrate in right lung, pleural effusions | X-ray: bilateral upper quadrant infiltrates | CT thorax: bilateral infiltrative consolidations | X-ray: bilateral infiltrative consolidations |
Microbiology | BAL: 6.2% intracellular yeasts 8×103 CFU/mL, Candida glabrata Sputum: C glabrata Zenkeŕs diverticel culture: C glabrata Blood: sterile Urine: sterile |
BAL: 55% intracellular yeasts >105 CFU/mL Candida albicans Sputum: C albicans, Citrobacter freundii Blood: sterile Urine: sterile Central venous line: sterile |
BAL: 0.4% intracellular yeasts 4×103 CFU/mL, C albicans 5 × 102 CFU/mL, C glabrata Sputum: C albicans Blood: sterile Urine: sterile Peritoneal fluid: C albicans, C glabrata Liquor PCR: Neisseria meningitidis |
BAL: 7.4% intracellular yeasts 5.6 × 104 CFU/mL, C albicans Sputum: C albicans Blood: Streptococcus mitis Urine: sterile Abdominal fluid: sterile Central venous line: sterile |
BAL: 0.6% intracellular yeasts 104 CFU/mL, C glabrata Sputum: pharyngeal flora Blood: sterile Urine: sterile |
Antibiotics | Moxifloxacin, fluconazole |
Piperacillin/tazobactam amphotericin B |
Ceftriaxone, fluconazole |
Levofloxacin amoxicillin/clavulanic acid fluconazol |
Amoxicillin/clavulanic acid |
Autopsy | None, patient survived | Lung tissue: Candida species, Enterobacter sakazakii | None, patient survived | Not permitted | Not permitted |
Abbreviations: BAL, bronchoalveolar lavage; CT, computed tomography; PCR, polymerase chain reaction.