A Case Report of Candida parapsilosis Empyema Thoracis
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Document Type
Event
Location
New Orleans, Louisiana
Event Website
https://www.medschool.lsuhsc.edu/DOM/Education/researchday/default.aspx
Start Date
4-2024 12:00 AM
End Date
4-2024 12:00 AM
Description
Title: A Case Report of Candida parapsilosis Empyema Thoracis
Author names: 1. Arielle Solomon 2. Kim Tran 3. Luke Sharrock 4. Allison Pinner 5. David Montgomery Degrees and Affiliations: 1. Third-year Medical Student. Louisiana State University Health Sciences Center New Orleans/University Medical Center, New Orleans, USA. 2. Fourth-year Medical Student. Louisiana State University Health Sciences Center New Orleans/University Medical Center, New Orleans, USA. 3. DO.Louisiana State University Health Sciences Center New Orleans/University Medical Center, New Orleans, USA. 4. MD.Louisiana State University Health Sciences Center New Orleans/University Medical Center, New Orleans, USA. 5. MD.Louisiana State University Health Sciences Center New Orleans/University Medical Center, New Orleans, USA.
ABSTRACT. Background: Candida empyema thoracis is a rare invasive candidiasis with poor prognosis. While more deadly in immunocompromised patients, it also occurs in the immunocompetent. There are no guidelines on treatment due to lack of research, but case reviews have shown antifungals, drainage, and surgery to be effective therapies.
The Case: A 63-year-old male with a past medical history of pulmonary emboli developed worsening left-sided chest pain associated with shortness of breath and productive cough that was occasionally blood-tinged. Extensive imaging and thoracentesis confirmed an expanding left-sided parapneumonic effusion that was drained and found to grow Streptococcus anginosis and Candida parapsilosis. A chest tube was placed and after multiple rounds of intrathoracic tPA the patient gradually improved following progressive removal of effusion and IV antibiotics and antifungals. The patient was then discharged with the remainder of his 18-day course of amoxicillin-clavulanate and fluconazole, with follow up imaging scheduled in the outpatient setting.
Discussion: Given the paucity of studies on Candida empyema, there are no definitive treatment guidelines or recommendations for this deadly infection. This patient’s course and outcome are fairly representative of the existing literature, including a 2021 retrospective study of 81 patients with Candida empyema at two academic centers which posited that optimal management included pleural drainage and fluconazole treatment.
Recommended Citation
Solomon, Arielle and Tran, Kim, "A Case Report of Candida parapsilosis Empyema Thoracis" (2024). Medicine Research Day. 62.
https://digitalscholar.lsuhsc.edu/mrd/2024mrd/mrdposters/62
A Case Report of Candida parapsilosis Empyema Thoracis
New Orleans, Louisiana
Title: A Case Report of Candida parapsilosis Empyema Thoracis
Author names: 1. Arielle Solomon 2. Kim Tran 3. Luke Sharrock 4. Allison Pinner 5. David Montgomery Degrees and Affiliations: 1. Third-year Medical Student. Louisiana State University Health Sciences Center New Orleans/University Medical Center, New Orleans, USA. 2. Fourth-year Medical Student. Louisiana State University Health Sciences Center New Orleans/University Medical Center, New Orleans, USA. 3. DO.Louisiana State University Health Sciences Center New Orleans/University Medical Center, New Orleans, USA. 4. MD.Louisiana State University Health Sciences Center New Orleans/University Medical Center, New Orleans, USA. 5. MD.Louisiana State University Health Sciences Center New Orleans/University Medical Center, New Orleans, USA.
ABSTRACT. Background: Candida empyema thoracis is a rare invasive candidiasis with poor prognosis. While more deadly in immunocompromised patients, it also occurs in the immunocompetent. There are no guidelines on treatment due to lack of research, but case reviews have shown antifungals, drainage, and surgery to be effective therapies.
The Case: A 63-year-old male with a past medical history of pulmonary emboli developed worsening left-sided chest pain associated with shortness of breath and productive cough that was occasionally blood-tinged. Extensive imaging and thoracentesis confirmed an expanding left-sided parapneumonic effusion that was drained and found to grow Streptococcus anginosis and Candida parapsilosis. A chest tube was placed and after multiple rounds of intrathoracic tPA the patient gradually improved following progressive removal of effusion and IV antibiotics and antifungals. The patient was then discharged with the remainder of his 18-day course of amoxicillin-clavulanate and fluconazole, with follow up imaging scheduled in the outpatient setting.
Discussion: Given the paucity of studies on Candida empyema, there are no definitive treatment guidelines or recommendations for this deadly infection. This patient’s course and outcome are fairly representative of the existing literature, including a 2021 retrospective study of 81 patients with Candida empyema at two academic centers which posited that optimal management included pleural drainage and fluconazole treatment.
https://digitalscholar.lsuhsc.edu/mrd/2024mrd/mrdposters/62