RESISTANT CANDIDA PNEUMONIA IN TWO PATIENTS WITH CHRONIC KIDNEY DISEASE
Patients with chronic kidney disease are at increased risk of sepsis and infection is the second leading cause of death in dialysis patients. Primary candida pneumonia is extremely rare and there is very little data on its treatment and outcome in chronic kidney disease patients. We report resistant candida pneumonia in two patients with chronic kidney disease. Both patients were successfully treated with anidulafungin which is a newer echinocandin. The current recommendation is not to treat candida isolated from sputum or bronchoalveolar lavage specimens. But our cases demonstrate that in the relevant clinical setting, positive sputum cultures cannot be ignored and prompt treatment can be lifesaving in this condition with high mortality. Both the patients developed generalized pigmentation which resolved in a few weeks which, to the best of our knowledge has never been reported with this drug before. It is unknown whether this adverse effect is limited to patients with chronic kidney disease.
26 April 2020 (online)
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
- 1 US Renal Data System: USRDS 2007 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, Bethesda, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2007.
- 2 Sarnak MJ, Jaber BL: Pulmonary infectious mortality among patients with end-stage renal disease. Chest 2001; 120 :1883.
- 3 Haron E, Vartivarian S, Anaissie E, Dekmezian R, Bodie GP. Primary Candida pneumonia. Experience at a large cancer center and review of the literature. Medicine (Baltimore) 1993;72:137.
- 4 Rello J, Esandi ME, Díaz E, Mariscal D, Gallego M, Valles J. The role of Candida sp isolated from bronchoscopic samples in nonneutropenic patients. Chest 1998;114:146.
- 5 Kontoyiannis DP, Reddy BT, Torres HA, Luna M, Lewis RE, Tarrand J, Bodey GP, Raad II. Pulmonary candidiasis in patients with cancer: an autopsy study. Clin Infect Dis 2002;34:400.
- 6 Franquet T, Müller NL, Lee KS, Oikonomou A, Flint JD. Pulmonary candidiasis after hematopoietic stem cell transplantation: thin-section CT findings. Radiology. 2005;236:332.
- 7 Pappas PG, Kauffman CA, Andes D, Benjamin DK Jr, Calandra TF, Edwards JE Jr, Filler SG, Fisher JF, Kullberg BJ, Ostrosky-Zeichner L, Reboli AC, Rex JH, Walsh TJ, Sobel JD. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 2009;48:503.
- 8 Reboli AC, Rotstein C, Pappas PG, Chapman SW, Kett DH, Kumar D, Betts R, Wible M, Goldstein BP, Schranz J, Krause DS, Walsh TJ. Anidulafungin Study Group: Anidulafungin versus fluconazole for invasive candidiasis. N Engl J Med. 2007;356:2472.