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Candida infection of the salivary glands is extremely rare, and a parotid gland infection with Candida tropicalis in an immunocompetent patient has, to the best of our knowledge, never been described before.
A 76-year-old male with known bilateral oncocytic parotid lesions and antibiotic suppression therapy for a vascular endograft infection presented with fever and a tender red mass in the left parotid region. Although a bacterial infection of the parotid gland was suspected at first, cultures of parotid cyst aspirate yielded C. tropicalis. Once the Gram stain indicated the presence of yeast cells, fluconazole therapy was initiated. Follow-up after 3 weeks showed resolution of the infection and antifungal therapy was ceased.
With increasing and widespread antibiotic use, this case underlines the emergence of uncommon pathogens by antibiotic selection pressure. This shift in causative pathogens will not only result in an increase in Candida infections at known body sites but will also lead to infection of less common anatomical sites. Clinicians should recognize this trend and adjust their differential diagnosis accordingly.