Primary Candida glabrata Infection of a Pancreatic Pseudocyst

This study describes a case of an 80-year-old patient admitted to our hospital with mid-epigastric pain, nausea, vomiting, and persistent fever for the last two days, after an episode of acute gallstone pancreatitis six weeks earlier. On admission, the patient was clinically stable with leukocytosis, high serum amylase levels, and high CRP levels. An abdominal CT scan showed a well-circumscribed, thick-walled fluid collection with air-fluid levels suggestive of an infected pancreatic pseudocyst. The patient underwent exploratory laparotomy in which fluid aspiration, removal of necrotic tissue, placement of drainage tube, and cholecystectomy were performed. Cultures from the pseudocyst revealed Candida glabrata. Antibiotics were discontinued, and intravenous antifungal therapy with anidulafungin was initiated at a loading dose of 200 mg, followed by a maintenance dose of 100 mg daily. The patient's condition improved shortly thereafter, with resolution of fever and normalization of laboratory tests. After three weeks of antifungal therapy, with no positive cultures from the drainage tube and no pathological findings on repeat CT, the patient was discharged from the hospital. He was doing well at six- and 12-month follow-ups.