title: [A case of Candida glabrata empyema].
abstract: A 72-year-old man was admitted to our hospital because of a low grade fever and malaise. He had received a middle to lower esophagectomy and proximal gastrectomy with reconstruction of a gastric conduit for esophageal cancer 12 years previously. Chest X-ray and CT scan revealed massive pleural effusion and consolidations on the right side. Candida glabrata was isolated 4 times from pleural fluid specimens. Candida antigen was negative in both serum and pleural effusion. However, while serum beta-D-glucan was negative, the level of beta-D-glucan in pleural effusion was extremely elevated. Thus, the patient was diagnosed as having C. glabrata empyema. He was treated with insertion of a thoracostomy tube followed by intrapleural instillation of amphotericin B and intravenous administration of micafungin. Pleural effusion was reduced and the repeated culture of the pleural effusion became negative after 27 days of treatment. Empyema with C. glabrata is rare and the present case is the second report of the disease in the Japanese literature.
authors: Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital.
authors: Hironori
authors: H
authors: Uruga
authors: Atsushi
authors: A
authors: Miyamoto
authors: Yuka
authors: Y
authors: Beika
authors: Takahiro
authors: T
authors: Enomoto
authors: Hisashi
authors: H
authors: Takaya
authors: Nasa
authors: N
authors: Morokawa
authors: Kazuma
authors: K
authors: Kishi
authors: Kunihiko
authors: K
authors: Yoshimura
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D041221:Candida glabrata; D002177:Candidiasis / Q000628:therapy*; D054714:Echinocandins / Q000008:administration & dosage; D004653:Empyema / Q000628:therapy*; D006801:Humans; D055666:Lipopeptides / Q000008:administration & dosage; D008297:Male; D000077551:Micafungin; D013907:Thoracostomy
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000666:Amphotericin B; D000077551:Micafungin