title: Severe pneumonia due to infection withCandida kruseiin a case of suspected Middle East respiratory syndrome: A case report and literature review.
abstract: Candida krusei(C. krusei) pneumonia is a rare infection that is frequently associated with a poor outcome. The present study reports an unusual case ofC. kruseipneumonia that was initially suspected to be a Middle East respiratory syndrome (MERS) case. A 64-year-old Saudi Arabian male patient was admitted to our hospital with complaints of cough and dyspnea that persisted for 6 days. The patient presented fever (oral temperature, 38.5°C) and slight tachypnea (25 respirations/min). A chest computerized tomography demonstrated unclear lung fields, diffuse pathological changes in the two lungs and multiple lymphadenectasis in the retrocaval and para-aortic arch area. The patient received 95-98% oxygen (6 l/min) for 24 h, as well as sulbactam sodium/cefoperazone sodium (1:1) injection (3.0 g) every 12 h, oral oseltamivir capsules (75 mg/time) twice a day, medaron injection (80 mg/time) and 750 ml fluid infusion; however, he succumbed to the disease on day 2 after admission. The infection was diagnosed by sputum smear and culture subsequent to patient mortality. A sputum smear showed a large fungal infection and sputum culture revealed the presence ofC. kruseiinfection. Serum procalcitonin concentrations were 4.73 µg/l and 7.23 µg/l on days 2 and 3 after admission, respectively. In conclusion, the diagnosis ofCandidapneumonia should be strongly considered in the presence of growth ofCandidafrom a sputum culture and based on a suggestive computed tomography image. Tumescent diaphragmatic lymph nodes may also be an important symptom ofCandidapneumonia. Treatment should be initiated immediately to improve tissue oxygenation, restore cardiovascular function and improve other organ functions.
authors.affiliation: Emergency Department, Tiantai County People's Hospital, Taizhou, Zhejiang 317200, P.R. China.
authors.forename: Mingming
authors.initials: M
authors.lastname: Tan
authors.affiliation: Emergency Department, Tiantai County People's Hospital, Taizhou, Zhejiang 317200, P.R. China.
authors.forename: Junwei
authors.initials: J
authors.lastname: Wang
authors.affiliation: Emergency Department, Tiantai County People's Hospital, Taizhou, Zhejiang 317200, P.R. China.
authors.forename: Peiyang
authors.initials: P
authors.lastname: Hu
authors.affiliation: Emergency Department, Tiantai County People's Hospital, Taizhou, Zhejiang 317200, P.R. China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.affiliation: Emergency Department, Tiantai County People's Hospital, Taizhou, Zhejiang 317200, P.R. China.
authors.forename: Wanghua
authors.initials: W
authors.lastname: Xu
authors.affiliation: Emergency Department, Tiantai County People's Hospital, Taizhou, Zhejiang 317200, P.R. China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Chen
keywords: Candida krusei; Candida pneumonia; PCT