2025 Volume 32 Article ID: 32_R44
The detection of Candida species in respiratory tract specimens presents a diagnostic challenge, particularly in distinguishing between pneumonia and colonization. A definitive diagnosis often requires highly invasive procedures, such as lung biopsy. Here, we report a case of Candida pneumonia in a patient with febrile neutropenia, diagnosed clinically through radiological findings and tissue culture, which resulted in a fatal outcome despite medical intervention. The patient was a 72-year-old man undergoing chemotherapy for oropharyngeal cancer. On Day 13 of hospitalization, he developed febrile neutropenia, and by Day 16, he was transferred to the intensive care unit due to hypotension. Imaging studies revealed pneumonia characterized by ground-glass opacities and cavitary lesions. Although Candida albicans was the only organism isolated from sputum cultures and bronchoalveolar lavage fluid, distinguishing between colonization and active infection proved challenging. A definitive diagnosis of Candida pneumonia was established via tissue culture. However, the patient's condition worsened progressively, ultimately leading to his death on Day 39 of hospitalization. If characteristic imaging findings of Candida pneumonia are present and Candida is repeatedly detected in lower respiratory tract specimens of the immunocompromised patients, treatment for Candida pneumonia may be considered after excluding other possible clinical scenarios.
