ABSTRACT

Severe acute pancreatitis is frequently complicated by secondary infections that worsen outcomes, but fungal bloodstream infections are uncommon. We report a fatal case of Candida kefyr fungemia in a 38-year-old male with severe acute alcoholic pancreatitis. The patient presented with abdominal pain, vomiting, and altered sensorium, and developed multiorgan failure requiring intensive care, vasopressors, and dialysis. Despite broad-spectrum antibiotics and empiric caspofungin therapy, his condition deteriorated, and he succumbed. Post-mortem fungal cultures grew Candida kefyr, which was susceptible to fluconazole, voriconazole, amphotericin B, and caspofungin. Candida kefyr, previously considered a rare yeast, is now emerging as a pathogen particularly in critically ill and immunocompromised hosts. It demonstrates variable susceptibility patterns and has been associated with rapid acquisition of antifungal resistance, complicating management. This case shows the need of suspecting invasive fungal infection early in patients with severe pancreatitis and multi-organ failure who fail to respond to antibiotics. Timely identification and susceptibility-guided antifungal therapy remain critical for improving outcomes. Heightened clinical vigilance and improved diagnostic tools are essential for prompt recognition of C. kefyr infections in high-risk patients.