The Significance of<i>Candida albicans</i>in Human Sputum

Baum, Gerald L.

doi:10.1056/nejm196007142630204

Cited by 57 publications

(26 citation statements)

References 29 publications

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“…Because there is no pathognomonic clinical picture for Candida pneumonia, diagnosis has relied for years on detecting the presence of Candida in sputum or bronchoscopic specimens. However, each of these methods is subject to error since Candida is a normal inhabitant of the mouth, and can be recovered from sputum in 20 to 55% of normal subjects (21). In our study, only two patients with positive Candida cultures from lung biopsies had true Candida lung infection.…”

Section: Discussionmentioning

confidence: 57%

Significance of the Isolation of Candida Species from Respiratory Samples in Critically Ill, Non-neutropenic Patients

El-Ebiary

Torres

Fàbregas

et al. 1997

Am J Respir Crit Care Med

252

130

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The diagnosis of pulmonary candidiasis is still controversial. We undertook a prospective study on 25 non-neutropenic, mechanically ventilated (> 72 h) patients who died in our ICU with the aim of assessing the incidence and significance of the isolation of Candida species from quantitative cultures of immediate postmortem lung biopsies and different respiratory sampling techniques. Immediate postmortem respiratory samples (endotracheal aspirate, protected specimen brush [PSB], bronchoalveolar lavage [BAL], blind biopsies [average 14/patient], and bilateral bronchoscopically guided biopsies [two per patient]) were taken from all patients. Lung tissue specimens were histologically examined. Respiratory samples were classified as having Candida or otherwise. Ten (40%) patients had at least one pulmonary biopsy yielding Candida spp. Among these 10 patients with Candida isolates, only two had definite pulmonary candidiasis. A total of 470 microorganisms were isolated from 280 of 375 (77%) lung biopsy samples in all 25 patients. Candida species represented 9% (n = 40) of the isolates, corresponding to 10 patients (40%). In the 10 patients in whom Candida species was isolated from pulmonary biopsies, this was always associated with the isolation of the same microorganism from one of the sampling methods. Quantitative cultures of Candida species from different sampling methods correlated well among each other but could not discriminate the presence from absence of Candida pneumonia. A logistic regression model adjusted for the presence of antibiotics, days of antibiotic treatment, mechanical ventilation period, age, ARDS, parenteral nutrition, and gender did not show any independent risk factor for developing positive pulmonary samples for Candida species. The incidence of Candida isolation from pulmonary biopsies in critically ill mechanically ventilated, non-neutropenic patients who die is high (40%). However, the incidence of definite Candida pneumonia was 8%. We also found that Candida colonization is uniform throughout the different lung regions, and that the presence of Candida in respiratory samples, independently of quantitative cultures, is not a good marker of Candida pneumonia in critically ill, non-neutropenic, non-AIDS patients.

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Section: Discussionmentioning

confidence: 57%

Significance of the Isolation of Candida Species from Respiratory Samples in Critically Ill, Non-neutropenic Patients

El-Ebiary

Torres

Fàbregas

et al. 1997

Am J Respir Crit Care Med

252

130

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“…Nothing is to be seen for the first 24 hours, though an occasional subject com¬ plained of slight itching. In 36 to 72 hours, tiny, discrete papules emerge on an erythematous background.…”

Section: Evolution Of Lesionsmentioning

confidence: 99%

The Biology of Experimental Human Cutaneous Moniliasis (Candida Albicans)

Maibach¹

1962

Arch Dermatol

166

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“…A cândida representa parte da flora normal, sendo cultivado a partir da cavidade oral em 7% da população 11 . O tratamento da laringite fúngica constitui-se no uso de anti-fúngicos sistêmicos, embora alguns autores considerem, para pacientes imunocompetentes, uma terapia inicial com agentes tópicos como a nistatina por período mínimo de três semanas antes do uso dos agentes sistêmicos.…”

Section: Discussionunclassified

Candidíase laríngea isolada em paciente imunocompetente: relato de caso e revisão literária pertinente

Perazzo

Martin²,

Moura³

et al. 2004

Rev. Bras. Otorrinolaringol.

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At ravés de revisão de literatura, confirma-se que infecção laríngea por cândida é uma entidade rara e usualmente associada a infecção pulmonar ou candidíase disseminada 1 . Candidíase em laringe de forma isolada (C.L.I.) é uma patologia ainda mais rara, e comumente relacionada a pacientes imunodeficientes 2 . Sabe-se que à laringoscopia direta, a candidíase pode apresentar achados físicos pobres como simples hiperemia local ou mesmo leucoplasia, mimetizando patologias como DRGE até neoplasias, fazendo, pois, parte do diagnóstico diferencial. Encontramos e documentamos em nosso serviço um caso de infecção por cândida de forma isolada em laringe (C.L.I.) em paciente imunocompetente. Havia comprometimento laríngeo importante, inclusive com lesão deformante em epiglote, simulando processo neoplásico. O diagnóstico foi estabelecido por videolaringoscopia e 2 biópsias da lesão encontrada, sendo os materiais obtidos submetidos a 2 estudos histopatológicos. Tomamos o cuidado de afastar síndromes imunodeficitárias, inclusive de etiologia viral, através de pesquisa sorológica e investigação sobre abuso de corticoesteróides ou antibióticos sistêmicos. Fizemos o follow-up do paciente per e pós tratamento com antifúngico sistêmico, acompanhando evolução e melhora através da endoscopia e sinais clínicos. Aft er a literature revision it is confirmed that the larynx candidiasis is rare and usually associated with lungs infection or systemic candidiasis. The larynx isolated form is more rare and seldom associated to immunological disease. It is known that through endoscopic examination, the candidiasis of larynx can show a single local erythema or leucoplasy, simulating G.E.R.D. or even neoplasia, which are the main differential diagnosis. We reported in our hospital an immunocompetent patient with isolated laryngeal candidiasis. There was an important involvement of larynx with degenerative lesions on epyglote, simulating a neoplasic process. The diagnosis was confirmed by biopses and histophatologic analyses. We crossed off hypotheses corticosteroids and antibiotics abuse. We followed up during and after the treatment with antifungeal by the use of endoscopic and clinical improvement. Rev Bras Otorrinolaringol. V.70, n.2, 278-82, mar./abr. 2004 Palavras-chave: candidíase, laringe, isolada. CASE REPORT RELATO DE CASO

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The Significance ofCandida albicansin Human Sputum

Cited by 57 publications

References 29 publications

Significance of the Isolation of Candida Species from Respiratory Samples in Critically Ill, Non-neutropenic Patients

Significance of the Isolation of Candida Species from Respiratory Samples in Critically Ill, Non-neutropenic Patients

The Biology of Experimental Human Cutaneous Moniliasis (Candida Albicans)

Candidíase laríngea isolada em paciente imunocompetente: relato de caso e revisão literária pertinente

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