Invasive Pulmonary Candidiasis in a Patient Requiring Chronic Total Parenteral Nutrition

Abstract

ABSTRACT The complications of total parenteral nutrition (TPN) in critically ill patients on short-term supplementation are well-established in the literature. However, data on managing complications, including fungal infections, in those requiring chronic TPN are lacking. The risk of fungal infections in patients requiring long-term TPN is multifactorial, including mechanisms that lead to immune system dysregulation, translocation, and seeding. Current clinical practice favors percutaneous endoscopic gastrostomy formation in patients requiring continued parenteral nutritional support, but in some patients who have undergone extensive abdominal surgeries, a percutaneous endoscopic gastrostomy tube is infeasible. We present a 42-year-old woman requiring chronic TPN who was found to have cavitary pulmonary candidiasis.