Suspected allergic bronchopulmonary candidiasis in a patient with concurrent multidrug-resistant bacterial pneumonia: A case report.
Xianxian Wu, Tongxin Zang, Yingbei Liu et al.
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Case in brief
A 70-year-old man with a history of hypertension and cerebral infarction presented with sudden right limb weakness and was diagnosed with hemorrhagic cerebral infarction. Despite broad-spectrum antibiotics, he developed persistent fever and pulmonary infiltrates. Elevated total IgE and the presence of Candida albicans in sputum led to a diagnosis of allergic bronchopulmonary candidiasis alongside multidrug-resistant pneumonia. Treatment with ceftazidime-avibactam, nebulized polymyxin B, voriconazole, and corticosteroids resulted in clinical improvement and resolution of pulmonary infiltrates.
Diagnostic / clinical pearl
High total IgE levels and isolation of Candida in patients with persistent pulmonary infiltrates should prompt consideration of allergic bronchopulmonary candidiasis, especially in the absence of asthma.
Why it matters
This case highlights that allergic bronchopulmonary candidiasis can occur in older patients and emphasizes the importance of early corticosteroid and antifungal therapy for rapid clinical improvement.