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Lack of efficacy: case reportA 53-year-old woman exhibited lack of efficacy during treatment with fluconazole for oesophageal candidiasis. The woman, who had a history stage IV lung adenocarcinoma treated with unspecified chemoradiotherapy and immunotherapy, presented due to fever, abdominal pain, diarrhoea and haematochezia. The symptoms were similar to a recent episode of unspecified innune-checkpoint inhibitor colitis, which improved with unspecified corticosteroids. She had radiation oesophagitis, which showed minimal response to unspecified corticosteroids. Hence, infliximab was started. Thereafter, a new distal superficial oesophageal cytomegalovirus ulcer was successfully treated with ganciclovir. Due to continued haemtochezia, upper endoscopy was performed, which showed severe oesophageal candidiasis. She received IV fluconazole [dosage not stated] for 14 days. Despite the treatment, she developed spontaneous oesophageal perforation followed by septic shock and hydropneumothorax. Pleural fluid culture grew Candida albicans (lack of efficacy). At that time, her family enrolled her in home hospice. She died a few days later [immediate cause of death not stated].
Lack of efficacy: case reportA 53-year-old woman exhibited lack of efficacy during treatment with fluconazole for oesophageal candidiasis. The woman, who had a history stage IV lung adenocarcinoma treated with unspecified chemoradiotherapy and immunotherapy, presented due to fever, abdominal pain, diarrhoea and haematochezia. The symptoms were similar to a recent episode of unspecified innune-checkpoint inhibitor colitis, which improved with unspecified corticosteroids. She had radiation oesophagitis, which showed minimal response to unspecified corticosteroids. Hence, infliximab was started. Thereafter, a new distal superficial oesophageal cytomegalovirus ulcer was successfully treated with ganciclovir. Due to continued haemtochezia, upper endoscopy was performed, which showed severe oesophageal candidiasis. She received IV fluconazole [dosage not stated] for 14 days. Despite the treatment, she developed spontaneous oesophageal perforation followed by septic shock and hydropneumothorax. Pleural fluid culture grew Candida albicans (lack of efficacy). At that time, her family enrolled her in home hospice. She died a few days later [immediate cause of death not stated].
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