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Pulmonary candidiasis. A clinical and pathological correlation.

H D Rose, N K Sheth

    Archives of Internal Medicine
    |June 1, 1978
    PubMed
    Summary

    Pulmonary candidiasis in patients with systemic Candida infection typically arises from hematogenous dissemination, not aspiration. Infected venous catheters were a common source of candidemia leading to lung invasion.

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    Area of Science:

    • Medicine
    • Infectious Diseases
    • Pathology

    Background:

    • Systemic Candida infections can lead to disseminated disease, including pulmonary involvement.
    • Understanding the origins and mechanisms of pulmonary candidiasis is crucial for patient outcomes.

    Observation:

    • A 13-year prospective autopsy study examined 30 patients with systemic Candida infection.
    • Eleven patients (36.7%) had tissue-verified pulmonary candidiasis.
    • Pulmonary candidiasis was primarily associated with hematogenous dissemination (9/11 patients).

    Findings:

    • Aspiration Candida pneumonia was rare, occurring in only two patients.
    • Hematogenous spread led to multiple organ invasion and pulmonary involvement.
    • Infected indwelling venous catheters were identified as the source of candidemia in six patients.
    • Candida organisms within pulmonary vessels caused necrotizing vasculitis and parenchymal invasion.

    Implications:

    • Pulmonary candidiasis predominantly results from hematogenous seeding rather than direct aspiration.
    • Identifying and managing sources of candidemia, such as infected catheters, is critical.
    • The mechanism involves vasculitis and subsequent fungal invasion of lung tissue.

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