RESUMO
Candida auris is a deadly fungal pathogen able to cause fatal symptoms in immunocompromised patients. It may be misidentified and difficult to clinically diagnose. The guidelines are to employ Echinocandin and Amphotericin B in the treatment, but the following study elucidates successful treatment of infection by a combination of three classes of antifungal drugs; never reported before. We present a patient with fulminant acute disseminated encephalomyelitis and neutropenia who developed invasive candidiasis despite appropriate antifungal therapy. We successfully treated ongoing candidemia with three antifungal drugs which lead to the resolution of fungemia after 18 days of treatment. Isolation, segregation, waste disposal, and deep cleaning technique were also followed as recommended by the Infectious Diseases Society of America guidelines. First report ofCandidemia in an immunocompromised patient was successfully treated with three classes of antifungal drugs, IV Micafungin, Amphotericin B, and Posaconazole for nearly 18 days.
RESUMO
We present the case of a 54-year-old male, who presented with respiratory complaints four months after he underwent renal transplantation. Bronchoscopy showed ulcerated mucosa of the left main bronchus and computed tomography (CT) of the thorax showed foci of air within the bronchial wall. A biopsy from the lesion showed septate fungal hyphae, dichotomously branching at acute angles. A locally invasive Aspergillus ulcerative tracheobronchitis with no parenchymal involvement is an important cause of tracheobronchitis in post-renal transplant patients. An early diagnosis and institution of appropriate treatment can improve the outcome. A combination treatment of caspofungin and voriconazole can be considered if patient is not responding to voriconazole alone.