Abstract
The diagnosis of Candida pneumonia is a difficult one to make, and some experts often question whether the entity truly exists. This article assimilates the information currently available regarding Candida pulmonary infection to elucidate the presentation of the disease and the hosts in which it occurs. It also describes how to interpret the presence of Candida in respiratory secretions from both immunocompetent and immunocompromised patients. Finally, it describes how the diagnosis of Candida pneumonia can be made, which patients with suspected disease should be treated, and which antifungal agents should be used.
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References and Recommended Reading
Masur H, Rosen PP, Armstrong D: Pulmonary disease caused by Candida species. Am J Med 1977, 63:914–925.
Mohsenifar Z, Chopra SK, Johnson BL, Simmons DH: Candida pneumonia: experience with 20 patients. West J Med 1979, 131:196–200.
Haron E, Vartivarian S, Anaissie E, et al.: Primary Candida pneumonia: experience at a large cancer center and review of the literature. Medicine (Baltimore) 1993, 72:137–142.
Ko SC, Chen KY, Hsueh PR, et al.: Fungal empyema thoracis: an emerging clinical entity. Chest 2000, 117:1672–1678.
Kanj SS, Welty-Wolf K, Madden J, et al.: Fungal infection in lung and heart-lung transplant recipients. Report of 9 cases and review of the literature. Medicine (Baltimore) 1996, 75:142–156.
Chen KY, Ko SC, Hsueh PR, et al.: Pulmonary fungal infection: emphasis on microbiological spectra, patient outcome, and prognostic factors. Chest 2001, 120:177–184.
Schwesinger G, Junghans D, Schroder G, et al.: Candidosis and aspergillosis as autopsy findings from 1994 to 2003. Mycoses 2005, 48:176–180.
Roosen J, Frans E, Wilmer A, et al.: Comparison of premortem clinical diagnoses in critically ill patients and subsequent autopsy findings. Mayo Clin Proc 2000, 75:562–567.
Meduri GU: Diagnosis and differential diagnosis of ventilator-associated pneumonia. Clin Chest Med 1995, 16:61–93.
Chastre J, Fagon JY: Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002, 165:867–903.
Guidelines for the management of adults with hospitalacquired, ventilator-associated, and healthcare-associated pneumonia. American Thoracic Society. Am J Respir Crit Care Med 2005, 171:388–416.
Wood GC, Mueller EW, Croce MA, et al.: Candida sp. isolated from bronchoalveolar lavage: clinical significance in critically ill trauma patients. Intensive Care Med 2006, 32:599–603.
el-Ebiary M, Torres A, Fabregas N, et al.: Significance of the isolation of Candida species from respiratory samples in critically ill, non-neutropenic patients. An immediate postmortem histologic study. Am J Respir Crit Care Med 1997, 156(2 Pt 1):583–590.
Murray PR, Van Scoy RE, Roberts GD: Should yeasts in respiratory secretions be identified? Mayo Clin Proc 1977, 52:42–45.
Eggimann P, Calandra T, Fluckiger U, et al.: Invasive candidiasis: comparison of management choices by infectious disease and critical care specialists. Intensive Care Med 2005, 31:1514–1521.
Barenfanger J, Arakere P, Cruz RD, et al.: Improved outcomes associated with limiting identification of Candida spp. in respiratory secretions. J Clin Microbiol 2003, 41:5645–5649.
Pittet D, Monod M, Suter PM, et al.: Candida colonization and subsequent infections in critically ill surgical patients. Ann Surg 1994, 220:751–758.
Leon C, Ruiz-Santana S, Saavedra P, et al.: A bedside scoring system (“Candida score”) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization. Crit Care Med 2006, 34:730–737.
Ostrosky-Zeichner L, Alexander BD, Kett DH, et al.: Multicenter clinical evaluation of the (1→3) beta-d-glucan assay as an aid to diagnosis of fungal infections in humans. Clin Infect Dis 2005, 41:654–659.
De Pauw B, Walsh TJ, Donnelly JP, et al.: Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 2008, 46:1813–1821.
Molnar TF: Current surgical treatment of thoracic empyema in adults. Eur J Cardiothorac Surg 2007, 32:422–430.
Colice GL, Curtis A, Deslauriers J, et al.: Medical and surgical treatment of parapneumonia effusions: an evidence-based guideline. Chest 2000, 18:1158–1171. [Published erratum appears in Chest 2001, 19:319.]
Coote N, Kay ES: Surgical versus non-surgical management of pleural empyema. Cochrane Database Syst Rev 2008, 4:CD001956.
Drew RH, Dodds Ashley E, Benjamin DK Jr, et al.: Comparative safety of amphotericin B lipid complex and amphotericin B deoxycholate as aerosolized antifungal prophylaxis in lung-transplant recipients. Transplantation 2004, 77:232–237.
Rijnders BJ, Cornelissen JJ, Slobbe L, et al.: Aerosolized liposomal amphotericin B for the prevention of invasive pulmonary aspergillosis during prolonged neutropenia: a randomized, placebo-controlled trial. Clin Infect Dis 2008, 46:1401–1408.
Olson JA, Adler-Moore JP, Schwartz J, et al.: Comparative efficacies, toxicities, and tissue concentrations of amphotericin B lipid formulations in a murine pulmonary aspergillosis model. Antimicrob Agents Chemother 2006, 50:2122–2131.
Fischman AJ, Alpert NM, Livni E, et al.: Pharmacokinetics of 18F-labeled fluconazole in healthy human subjects by positron emission tomography. Antimicrob Agents Chemother 1993, 37:1270–1277.
Petraintiene R, Petraitis V, Groll AH, et al.: Antifungal efficacy of caspofungin (MK-0991) in experimental pulmonary aspergillosis in persistently neutropenic rabbits: pharmacokinetics, drug disposition, and relationship to galactomannan antigenemia. Antimicrob Agents Chemother 2002, 46:12–23.
Garey KW, Rege M, Pai MP, et al.: Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin Infect Dis 2006, 43:25–31.
Azoulay E, Timsit JF, Tafflet M, et al.: Candida colonization of the respiratory tract and subsequent pseudomonas ventilator-associated pneumonia. Chest 2006, 129:110–117.
Delisle MS, Williamson DR, Perreault MM, et al.: The clinical significance of Candida colonization of respiratory tract secretions in critically ill patients. J Crit Care 2008, 23:11–17.
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Barkauskas, C.E., Perfect, J.R. Candida pneumonia: What we know and what we don’t. Curr Fungal Infect Rep 3, 21–31 (2009). https://doi.org/10.1007/s12281-009-0004-z
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DOI: https://doi.org/10.1007/s12281-009-0004-z