{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:13:59Z","timestamp":1784200439556,"version":"3.55.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n \n Bronchopulmonary candidiasis is a clinically common type of pulmonary fungal disease, primarily caused by infection with Candida species (mostly\n Candida albicans<\/jats:italic>\n ). It typically manifests as a secondary infection when the body\u2019s resistance is compromised. Clinically, bronchopulmonary candidiasis is primarily classified into three types: (1) bronchitic, (2) pneumonic, and (3) hypersensitivity.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This paper reports two cases of bronchopulmonary candidiasis. The first case presented with bronchitis-type manifestations. Imaging studies showed no evidence of severe pneumonia, but the patient had persistent airway hyperresponsiveness that led to difficulty in weaning from mechanical ventilation.\n Candida albicans<\/jats:italic>\n was identified in the bronchoalveolar lavage fluid (BALF), supporting a diagnosis of Candida bronchitis. The patient was successfully weaned following targeted antifungal therapy. The second case presented with the pneumonia variant, clinically manifesting as severe pneumonia.\n Candida albicans<\/jats:italic>\n was also isolated from the BLAF. The patient recovered and was discharged after receiving combination antifungal therapy with caspofungin and isavuconazole.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Serological markers for fungal infection were normal in both patients, but pathogen cultures from BALF revealed\n Candida albicans<\/jats:italic>\n growth. Combined with clinical presentations, these findings supported diagnoses of invasive Candida bronchitis and pneumonia, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This report indicates that the clinical manifestations of bronchopulmonary candidiasis may be atypical relative to radiological and serological indicators. Although a single positive BALF culture is insufficient for definitive diagnosis, its integration with clinical characteristics can provide a crucial diagnostic clue. These cases thus provide valuable reference points for clinical diagnosis, though definitive validation through histopathological examination remains necessary.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2025.1747382","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T06:30:00Z","timestamp":1768372200000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Diagnosis of bronchopulmonary candidiasis\u2014refractory airway hyperresponsiveness, severe pneumonia, and normal serological markers"],"prefix":"10.3389","volume":"12","author":[{"given":"Dalong","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People\u2019s Hospital), Zhengzhou","place":["Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanjie","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People\u2019s Hospital), Zhengzhou","place":["Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongrui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People\u2019s Hospital), Zhengzhou","place":["Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People\u2019s Hospital), Zhengzhou","place":["Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingguo","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People\u2019s Hospital), Zhengzhou","place":["Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1007\/s00134-019-05906-5","article-title":"Diagnosis of severe respiratory infections in immunocompromised patients.","volume":"46","author":"Azoulay","year":"2020","journal-title":"Intensive Care Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/j.pccm.2025.02.007","article-title":"Clinical characteristics of patients with positive fungal pathogens during acute exacerbation of chronic obstructive pulmonary disease: a retrospective study.","volume":"3","author":"Luo","year":"2025","journal-title":"Chin Med J Pulmonary Crit Care Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3760\/cma.j.issn.0578-1426.2020.01.002","article-title":"[Chinese consensus on the diagnosis and management of adult candidiasis].","volume":"59","year":"2020","journal-title":"Zhonghua Nei Ke Za Zhi."},{"key":"B4","doi-asserted-by":"publisher","first-page":"145","DOI":"10.2174\/1874306401206010145","article-title":"Chronic candidal bronchitis: a consecutive series.","volume":"6","author":"Johnson","year":"2012","journal-title":"Open Respir Med J."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e9650","DOI":"10.1097\/MD.0000000000009650","article-title":"Candida pneumonia with severe clinical course, recovery with antifungal therapy and unusual pathologic findings: a case report.","volume":"97","author":"Dermawan","year":"2018","journal-title":"Medicine."},{"key":"B6","doi-asserted-by":"publisher","first-page":"923","DOI":"10.3390\/jof8090923","article-title":"Candida glabrata empyema thoracis\u2014a post-COVID-19 complication.","volume":"8","author":"Swaminathan","year":"2022","journal-title":"JoF."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/8039803","article-title":"Candida krusei empyema thoracis: a community-acquired infection requiring a high index of suspicion.","volume":"2018","author":"Bukamur","year":"2018","journal-title":"Case Rep. 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