Pulmonary Candidiasis in an Immunocompetent Patient

Abstract

Clinically, fungi infections of the respiratory system are uncommon. The pathogen culture and the clinical characteristics are frequently used in the clinical diagnosis of fungi. Two different patterns of invasive pulmonary candidiasis have been described: primary candida bronchopneumonia and secondary pulmonary disease arising from haematogenous dissemination or rarely primary bronchopneumonia. Primary candida bronchopneumonia is limited largely to immunocompromised patients and is thought to occur by aspiration of candida into the upper respiratory tract. This is a case of a 55-year-old male who presented with the chief complaint of dyspnoea on exertion, intermittent fever, and cough associated with expectoration of 1-month duration. The fever was moderate grade and intermittent without chills, rigours, or night sweats. Respiratory system examination revealed bilateral scattered course crackles in both lung fields. Chest X-ray revealed heterogeneous opacities in bilateral upper lobes and hyperinflation of the lung. Biopsy specimens from para hilar (centrilobular nodules) were obtained and stained with haematoxylin/eosin, periodic acid Schiff, and Gram stain. Clusters of pseudohyphae and budding yeasts were detected in the nodules, indicating candida infection. Sputum microscopy confirmed pulmonary candidiasis. The patient’s bronchoscopy was done and bronchoalveolar lavage was sent for investigations and the growth of candidiasis came positive.

Keywords

• aspiration
• cough
• dyspnoea on exertion
• fungal infections
• intermittent fever