RESISTANT CANDIDA PNEUMONIA IN TWO PATIENTS WITH CHRONIC KIDNEY DISEASE

Abstract Patients with chronic kidney disease are at increased risk of sepsis and infection is the second leading cause of death in dialysis patients. Primary candida pneumonia is extremely rare and there is very little data on its treatment and outcome in chronic kidney disease patients. We report resistant candida pneumonia in two patients with chronic kidney disease. Both patients were successfully treated with anidulafungin which is a newer echinocandin. The current recommendation is not to treat candida isolated from sputum or bronchoalveolar lavage specimens. But our cases demonstrate that in the relevant clinical setting, positive sputum cultures cannot be ignored and prompt treatment can be lifesaving in this condition with high mortality. Both the patients developed generalized pigmentation which resolved in a few weeks which, to the best of our knowledge has never been reported with this drug before. It is unknown whether this adverse effect is limited to patients with chronic kidney disease.