Candida glabrata and tropicalis pneumonia in an immunocompetent patient

Purpose: To describe the hospital course of an immunocompetent patient with necrotizing Candida pneumonia. While Candida species are common causes of invasive fungal infections, lower respiratory tract infections due to Candida are rare, especially in non-neutropenic patients. Mortality associated with invasive Candida can be high (47%) with limited evidence on optimal treatment. When C. glabrata is suspected, an echinocandin is preferred at least until susceptibility of isolate can be confirmed.

Methods: We describe a 72 year old immunocompetent male admitted to our institution after a trip to Ecuador.   He was admitted with sepsis and received empiric treatment for both histoplasmosis and tuberculosis.

Results: This patient was discovered to have Candida glabrata and tropicalis pneumonia upon tissue biopsy and was treated successfully with micafungin.

Conclusion: Though uncommon, Candida pneumonia should be suspected as part of the differential diagnosis of sepsis.