Fatal Community-Acquired Primary Candida Pneumonia in an Alcoholic Patient

A 54-year-old alcoholic woman developed fulminant community-acquired pneumonia. Despite receiving intensive support measures, she died four days after admission. An autopsy revealed bronchopneumonia with clusters of pseudohyphae and yeast-like fungi, and Candida albicans was isolated from both tracheal aspiration specimens obtained on admission and the postmortem lungs. The absence of vessel invasion or any other organ involvement led to a diagnosis of primary Candida pneumonia secondary to aspiration, rather than pulmonary seeding from systemic infection. Candida species isolated from respiratory tract samples are usually regarded as originating from colonization; however, the possibility for true Candida pneumonia should be taken into account, even in the setting of community-acquired pneumonia.