Pulmonary candidiasis. A clinical and pathological correlation.

Thirty patients with systemic Candida infection underwent autopsy during a 13-year prospective study. Eleven patients had tissue-verified pulmonary candidiasis. Nine of these patients had hematogenous dissemination, as evidenced by multiple organ invasion; two had aspiration pneumonia with lung involvement only. Aspiration Candida pneumonia is rare. Pulmonary candidiasis usually arises from a focus of infection implanted during hematogenous dissemination. An infected indwelling venous catheter was the source of candidemia in six of these patients. Organisms in the lumen of pulmonary vessels caused a necrotizing vasculitis and appeared to invade the parenchyma from these areas.