Case report describes multidrug-resistant Candida tropicalis IPFD misdiagnosed as malignancy before caspofungin response.

This study is a case report and literature review involving a single patient hospitalized with invasive pulmonary fungal disease (IPFD) caused by multidrug-resistant Candida tropicalis and a history of lymphoma. The patient was initially misdiagnosed at another hospital, leading to a delay in appropriate management. The intervention involved treatment with fluconazole followed by caspofungin, alongside an exploration of the underlying causes of the patient's immunosuppression. No comparator group was utilized due to the observational nature of the report.

The patient did not respond to fluconazole therapy. However, subsequent treatment with caspofungin resulted in substantial clinical improvement. Secondary outcomes included the discovery of a cutaneous malignancy and the identification of the specific cause of the patient's immunosuppression. No adverse events, serious adverse events, discontinuations, or specific tolerability data were reported in the available text.

Key limitations include the rarity of IPFD caused by multidrug-resistant Candida tropicalis and the small sample size of one case. The practice relevance highlights that IPFD caused by C. tropicalis can present with unusual manifestations, potentially leading to misdiagnosis as malignancy. Clinicians must monitor response to antifungals carefully due to the risk of resistance in circulating C. tropicalis strains and should actively explore underlying causes of immunosuppression in such cases.