Peripheral Smear as a Diagnostic Lifesaver: A Case Report of Candida Pelliculosa Fungemia in an Infant
DOI:
https://doi.org/10.21276/apalm.3670Keywords:
Candida pelliculosa, Peripheral smear, Fungemia, Infant, ThrombocytopeniaAbstract
Invasive fungal infections pose a serious clinical challenge, contributing considerably to illness and death among high-risk groups, especially newborns and patients with compromised immunity. While Candida albicans is the most frequently identified species, emerging pathogens such as Candida pelliculosa are increasingly reported. We report the case of a 6-month-old infant with cholestasis and persistent thrombocytopenia unresponsive to broad-spectrum antibiotics. Peripheral smear examination revealed budding yeast cells suggestive of fungemia, later confirmed as Candida pelliculosa by culture and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS). Intravenous fluconazole led to significant clinical and hematologic recovery. This case highlights the diagnostic utility of peripheral smear for early detection of rare fungal pathogens, particularly in resource-limited settings lacking rapid diagnostics. High clinical suspicion and timely antifungal therapy are critical for favorable outcomes in infantile candidemia.
References
1. Soriano A, Honore PM, Puerta-Alcalde P, Garcia-Vidal C, Pagotto A, Gonçalves-Bradley DC, et al. Invasive candidiasis: current clinical challenges and unmet needs in adult populations. J Antimicrob Chemother. 2023 Jul;78(7):1569-85.
2. Bassetti M. Giacobbe DR, Vena A, Wolff M. Diagnosis and treatment of candidemia in the intensive care unit. Semin Respir Crit Care Med. 2019 Aug 40(4):524-39.
3. Rahate K, Arshi A, Barai RS, Chakraborty S, Idicula-Thomas S. EpiCandIn: An open online resource for epidemiology of Candida infections in India. Indian J Med Res. 2024 Sep;159(6):576.
4. Muskett H, Shahin J, Eyres G. Harvey S, Rowan K, Harrison D. Risk factors for invasive fungal disease in critically ill adult patients: a systematic review. Crit Care. 2011 Nov;15(6):R287.
5. Suleyman G, Alangaden GJ. Nosocomial fungal infections: epidemiology, infection control, and prevention. Infect Dis Clin North Am. 2021 Dec:35(4):1027-53.
6. Zhang Z, Cao Y, Li Y, Chen X, Ding C, Liu Y. Risk factors and biofilm formation analyses of hospital-acquired infection of Candida pelliculosa in a neonatal intensive care unit. BMC Infect Dis. 2021 Jun;21(1):620.
7. Cai Z, Wei W, Cheng Z. Candida pelliculosa sepsis in a neonate: a case report. J Int Med Res. 2021 Jan;49(1):0300060520982804.
8. Yadav S. Sharma A, Kothari N, Jain V, Goyal S. Khatri M, et al. Candida pelliculosa infection in adults admitted in intensive care unit of tertiary care center: should we treat or not? Indian J Crit Care Case Rep. 2023 Sep;2(5):125.
9. Kim HR, Park BR, Lee MK. Effects of bacteria and yeast on WBC counting in three automated hematology counters. Ann Hematol. 2008 Jul;87(7):557-62.
10. Branda JA, Kratz A. Effects of yeast on automated cell counting. Am J Clin Pathol. 2006 Aug; 126(2):248-54.
11. Spatha E, Gheorghe LM, Chaliori I, Tsagarakis NJ, Patsiogiannis N, Chaniotaki SK. Candidemia in an orthopedic patient detected coincidentally by peripheral blood smear. Diagnostics. 2024 Nov;14(22):2597.
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Copyright (c) 2025 Richa Bhartiya, Vishal Tayade, Sayantani Saha, Pritisha Choudhury, Sushma Ramraje

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