SHM Converge Scientific Abstract ePoster Gallery-Rare Case of C. Parapsilosis Pneumonia in an Immunocompetent Patient

Pdf Summary

This case report describes a rare instance of <strong>necrotizing pneumonia caused by <em>Candida parapsilosis</strong></em> in a <strong>61-year-old immunocompetent, non-neutropenic man</strong>. Although Candida commonly colonizes the mouth and upper airways and is usually considered a contaminant in sputum cultures, invasive Candida pneumonia typically occurs in immunocompromised patients.  

The patient had a <strong>40 pack-year smoking history</strong> and a remote history of tuberculosis. He presented with <strong>7 days of dyspnea</strong>, hypoxia, tachycardia, respiratory distress, confusion, and severe sepsis with acute hypoxic/hypercapnic respiratory failure, AKI, and metabolic encephalopathy. Imaging showed a <strong>large left upper lobe infiltrate with cystic changes</strong>, progressing despite broad-spectrum antibiotics. Initial workup for bacterial, TB, and other fungal causes was negative or inconclusive.  

Because of persistent, worsening pneumonia, bronchoscopy was performed. BAL cultures later grew ***C. parapsilosis***, and repeat bronchoscopy with biopsy again confirmed the organism. A <strong>beta-D-glucan was elevated</strong>, supporting invasive fungal infection. After <strong>fluconazole</strong> was started on hospital day 17, the patient improved clinically, with better energy, reduced oxygen needs, and eventual discharge with outpatient follow-up imaging.  

The authors emphasize that although <em>Candida</em> pneumonia is rare, it should be considered when <strong>pneumonia worsens despite antibiotics</strong>, even in patients without obvious immunosuppression. They propose that <strong>chronic lung injury from smoking</strong> may predispose some immunocompetent patients to this infection.

Asset Subtitle

Raiya Habib

Meta Tag

Author List Anthony Nanajian, Christopher L. Bray, Matthew Calestino, Raiya Habib, Zeeshan Ismail

Category Clinical Vignettes

Concept Candida

Concept Candida parapsilosis

Concept Necrotizing Pneumonia

Concept Pulmonary fungal pneumonia

Concept Refractory Pneumonia

Distinguished Non-Finalist

Presenter Organization UCF- HCA North Florida Hospital

Presenting Author Raiya Habib

Track Adult

Keywords

Candida parapsilosis

necrotizing pneumonia

immunocompetent

non-neutropenic

bronchoalveolar lavage

fluconazole

beta-D-glucan

respiratory failure

smoking history

fungal infection

Candida

Candida parapsilosis

Necrotizing Pneumonia

Pulmonary fungal pneumonia

Refractory Pneumonia