Table 1.
Classification | Description and Pathophysiology |
---|---|
Spontaneous esophageal rupture | Direct inoculation of Candida into the pleural space after spontaneous esophageal rupture without any antecedent cardiothoracic surgery or invasive procedure |
Intrathoracic source | Candida inoculation into the pleural space via any of the following routes: (1) inoculation during intrathoracic (esophagus, lung, heart) surgery or invasive procedure; (2) inoculation via complications of these surgeries (eg, anastomotic leaks or perforation at the surgical site); (3) inoculation via trauma to the chest; (4) inoculation from oropharyngeal, retropharyngeal, or paraspinal infection to the pleural space; (4) esophageal cancer eroding into the lung with subsequent bronchopleural fistula formation; (5) bronchopleural fistula of unclear etiology |
Diaphragmatic translocation from GI source | Candida inoculation from an intra-abdominal source, across the diaphragm. The infection can originate from the following: (1) rupture of an intestinal viscous; (2) primary or secondary Candida peritonitis; (3) intra-abdominal surgery, hepatobiliary surgery, or complications from these surgeries; (4) subdiaphragmatic liver abscess; (5) pancreatitis and/or pancreatic-pleural fistula |
Recent pleural manipulation | Candida inoculation of the pleural space via repeated pleural effusion sampling or drainage, or indwelling chest tubes |
Pneumonia | Candida empyema originating from an infection of the lung, as in cases of aspiration pneumonia |
Unknown source | Most often involve chronic pleural effusion, for which the source of Candida is not apparent |
Abbreviations: GI, gastrointestinal.