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Recurrent fever of unknown fungal infection in a low-risk patient: A case report
Tang-Meng Guo1,2, Yu Ye3, Li-Li Huang4
1Department of Geriatrics.
Rationale:
Fungal infectious disease does not usually occur in low-risk patients. Clinicians tend to ignore the role of fungi in the fevers of low-risk patients. If there is not timely control of fungal infections and associated fever, the disease will continue to worsen, resulting in physical dysfunction or death.
Patient Concerns:
Recurrent fever continued for 1 month in a young adult.
Diagnoses And Interventions:
Non-albicans Candida (NAC) species probably was the main pathogen in this case based on the resolution of fever after capsofungin administration.
Outcomes:
The fever and the associated indicators, including white blood cell count, C-reaction protein, erythrocyte sedimentation rate, and BDG levels, showed improvement quickly. The patient left the hospital successfully after 18 days of caspofungin treatment. There was no recurrent fever at a follow-up of 1 year.
Lessons:
Clinicians should be aware that the incidence of fungal infection is increasing in low-risk patients. The BDG assay is still an effective tool used to diagnose invasive fungal diseases. Caspofungin is an effective drug for the treatment of some unknown fungal infections.
Insights
Fungal infections are increasingly seen in low-risk patients. Early diagnosis with beta-D-glucan (BDG) assays and treatment with caspofungin can effectively manage these serious infections.
Area of Science:
- Infectious Diseases
- Mycology
- Internal Medicine
Background:
- Fungal infections are uncommon in low-risk individuals.
- Clinicians often overlook fungal causes of fever in non-immunocompromised patients.
- Untreated fungal infections can lead to severe complications and mortality.
Observation:
- A young adult presented with a month of recurrent fever.
- The patient's fever resolved after treatment with caspofungin.
- Non-albicans Candida (NAC) species were suspected as the causative agent.
Findings:
- Treatment with caspofungin led to rapid improvement in fever and inflammatory markers (white blood cell count, C-reaction protein, erythrocyte sedimentation rate).
- Beta-D-glucan (BDG) levels also normalized.
- The patient was discharged after 18 days and remained fever-free at 1-year follow-up.
Implications:
- Clinicians must consider increasing fungal infection incidence in low-risk populations.
- The BDG assay is a valuable diagnostic tool for invasive fungal diseases.
- Caspofungin demonstrates efficacy in treating certain invasive fungal infections.
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