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. 2014 May 27;1(1):ofu026.
doi: 10.1093/ofid/ofu026. eCollection 2014 Mar.

Candida pneumonia in intensive care unit?

Ronny M Schnabel  1 , Catharina F Linssen  2 , Nele Guion  1 , Walther N van Mook  1 , Dennis C Bergmans  1
Affiliations

Candida pneumonia in intensive care unit?

Ronny M Schnabel et al. Open Forum Infect Dis. .

Abstract

It has been questioned if Candida pneumonia exists as a clinical entity. Only histopathology can establish the definite diagnosis. Less invasive diagnostic strategies lack specificity and have been insufficiently validated. Scarcity of this pathomechanism and nonspecific clinical presentation make validation and the development of a clinical algorithm difficult. In the present study, we analyze whether Candida pneumonia exists in our critical care population. We used a bronchoalveolar lavage (BAL) specimen database that we have built in a structural diagnostic approach to ventilator-associated pneumonia for more than a decade consisting of 832 samples. Microbiological data were linked to clinical information and available autopsy data. We searched for critically ill patients with respiratory failure with no other microbiological or clinical explanation than exclusive presence of Candida species in BAL fluid. Five cases could be identified with Candida as the likely cause of pneumonia.

Keywords: Candida; Zenker's diverticulum; bronchoalveolar lavage; pneumonia.

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Figures

Figure 1.
Figure 1.
Chest x-ray of case 1 patient showing bilateral micronodular infiltrations.
Figure 2.
Figure 2.
May-Grünwald-Giemsa stain (1000-fold) of case 1 patient bronchoalveolar lavage fluid showing intracellular microorganisms (arrow).
Figure 3.
Figure 3.
Thoracic computed tomography scan of case 1 patient showing bullae, interstitial abnormalities, fibrosis, and a cystic mediastinal abnormality (arrow).
See this image and copyright information in PMC

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