Severe pneumonia due to infection with Candida krusei in a case of suspected Middle East respiratory syndrome: A case report and literature review.

Candida krusei (C. krusei) pneumonia is a rare infection that is frequently associated with a poor outcome. The present study reports an unusual case of C. krusei pneumonia that was initially suspected to be a Middle East respiratory syndrome (MERS) case. A 64-year-old Saudi Arabian male patient was admitted to our hospital with complaints of cough and dyspnea that persisted for 6 days. The patient presented fever (oral temperature, 38.5°C) and slight tachypnea (25 respirations/min). A chest computerized tomography demonstrated unclear lung fields, diffuse pathological changes in the two lungs and multiple lymphadenectasis in the retrocaval and para-aortic arch area. The patient received 95-98% oxygen (6 l/min) for 24 h, as well as sulbactam sodium/cefoperazone sodium (1:1) injection (3.0 g) every 12 h, oral oseltamivir capsules (75 mg/time) twice a day, medaron injection (80 mg/time) and 750 ml fluid infusion; however, he succumbed to the disease on day 2 after admission. The infection was diagnosed by sputum smear and culture subsequent to patient mortality. A sputum smear showed a large fungal infection and sputum culture revealed the presence of C. krusei infection. Serum procalcitonin concentrations were 4.73 µg/l and 7.23 µg/l on days 2 and 3 after admission, respectively. In conclusion, the diagnosis of Candida pneumonia should be strongly considered in the presence of growth of Candida from a sputum culture and based on a suggestive computed tomography image. Tumescent diaphragmatic lymph nodes may also be an important symptom of Candida pneumonia. Treatment should be initiated immediately to improve tissue oxygenation, restore cardiovascular function and improve other organ functions.

Controlled growth of calcium oxalate crystal in bicontinuous microemulsions containing amino acids.

The growth of calcium oxalate (CaC(2)O(4)) crystal in water channels of three kinds of bicontinuous microemulsions, consisted of P-octyl polyethylene glycol phenylether (OP)/n-amyl alcohol/cyclohexane/water and above microemulsions containing tryptophan (Trp) or aspartic acid (Asp) has been studied. The products were characterized by transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FT-IR) and X-ray diffraction (XRD). The results indicated that both surfactant and amino acids all could prompt the growth of calcium oxalate monohydrate (COM) crystal, but the crystal morphology varied with the different microemulsions, pH values of the aqueous solution in channels and concentrations of the reactants. Various crystal morphologies such as butterfly-like, hollow and spiny spherical could be observed easily. A model of molecular identification--organized assembly--pervasion-combination balance was proposed to explain the formation mechanism of CaC(2)O(4) crystals in the microemulsions containing Asp.