Candida guilliermondii pneumonia:a case report and literature review
OBJECTIVE To summarize the pathogenesis,clinical manifestations,imaging characteristics,diagnosis and treatment of Candida guilliermondii pneumonia so as to boost the awareness of pulmonary mycosis and re-duce the incidence of missed diagnosis and misdiagnosis.METHODS The clinical data were collected from 1 patient with C.guilliermondii pneumonia who was treated in the First Medical Center of Chinese PLA General Hospital in Mar 2023,the clinical data included the major clinical symptoms,history of medication and treatment,imaging manifestations,underlying diseases and major positive signs.The diagnosis and treatment processes were summa-rized and analyzed,and the case review was carried out based on literature search.RESULTS The patient had type 2 diabetes mellitus,coronary atherosclerotic heart disease,hypothyroidism and paroxysmal atrial fibrillation.Cough,expectoration and asthma were the major symptoms.The result of clinical laboratory test showed that the level of fungal(1,3)-β-D-glucan was elevated,C.guilliermondii was detected positive by 3 times of sputum cul-ture,1 time of alveolar lavage fluid culture and metagenomic next generation sequencing(mNGS)for lavage fluid.The chest CT showed multiple patchy ground glass shadows and increased cord density in both lungs.Fluconazole did not relieve the symptoms,the reexamination of chest CT showed no absorption of focus,and the symptoms were alleviated by voriconazole;the reexamination of chest CT showed remarkable improvement of infection of both lungs,and the patient was discharged for stable condition.CONCLUSION The C.guilliermondii pneumonia is less common and is prevalent among the immunocompromised patients.Those patients are sensitive to triazoles,amphotericin B and fluorocytosine but are less sensitive to echinocandins.It is necessary to use antibiotics based on the result of drug susceptibility testing.
Fungal pneumoniaCandida guilliermondiiPulmonary infectionFluconazoleVoriconazoleMet-agenomic next generation sequencing
NETL
NSTL
万方数据
