Abstract
We experienced a case of candidiasis in a bleb detected during surgery for pneumothorax. The patient was an 18-year-old man. In October, 1999, he was diagnosed with left pneumothorax and improved with conservative therapy. In November, 1999, he presented cough and left anterior chest pain again, and was diagnosed with a recurrence of pneumothorax by chest Xray. The degree of collapse was 26%. A chest CT scan showed a cystic lesion in the left apex. We resected this cystic lesion and another in S6 segment with video assisted thoracic surgery (VATS). Histologically, the cystic lesion was a bleb, and granulation was found in the wall of the resected bleb. Furthermore, many multinucleated giant cells and hyphae of candida were found.
Cadidiasis is an opportunistic infection developing in the immunocompromised host. This case had no underlying disease or findings suggesting systemic candida infection. So, it is considering that candida made on invasion via airway and increased in a bleb, but relation between pneumothorax and candida infection were unclear. Recently primary pulmonary mycotic infection is not rare, so it is necessary to diagnose and cure it keeping in mind the possibility of this entity.
