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. 2024 Aug;8(3):273-276.
doi: 10.5811/cpcem.19426.

Community-Acquired Candida albicans Empyema Leading to Tension Physiology: A Case Report

Jason Cinti  1 , Paula Gomez  1 , Suneil Agrawal  1
Affiliations

Community-Acquired Candida albicans Empyema Leading to Tension Physiology: A Case Report

Jason Cinti et al. Clin Pract Cases Emerg Med. 2024 Aug.

Abstract

Introduction: A tension empyema, in which purulent material accumulates in the chest cavity and leads to cardiopulmonary dysfunction, is a rare complication of empyemas. Moreover, fungal empyemas that grow Candida albicans and cause tension physiology have not yet been previously described.

Case report: In this report, we present an immunocompetent 30-year-old male who presented to the emergency department with worsening shortness of breath and was found to have a left-sided fungal empyema causing tension physiology. Left chest thoracostomy yielded approximately 4 liters of purulent fluid. Pleural cultures eventually grew C albicans, and after antifungal therapy, surgical decortication of the lung, and a prolonged intensive care unit stay, the patient was discharged home in stable condition.

Conclusion: While mortality from C albicans empyemas that cause respiratory compromise is exceedingly high, our case highlights that aggressive management with rapid chest thoracostomy and antifungal therapy can lead to a favorable outcome.

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Conflict of interest statement

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

Image 1.
Image 1.
A. Axial view of initial computed tomography chest showing large left hydropneumothorax with complete left lung collapse (red arrow). B. Coronal view of significant rightward shift of the trachea and mediastinum (yellow arrow).
Image 2.
Image 2.
Repeat axial computed tomography chest with contrast on day six of intensive care unit admission showing persistent large empyema reduced in size (red arrow) with resolution of mediastinal shift. Chest tube still in place (yellow arrow), and bilateral ground-glass opacities present.
See this image and copyright information in PMC

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