Peripheral Smear as a Diagnostic Lifesaver: A Case Report of Candida Pelliculosa Fungemia in an Infant

Invasive fungal infections pose a serious clinical challenge, contributing considerably to illness and death among high-risk groups, especially newborns and patients with compromised immunity. While Candida albicans is the most frequently identified species, emerging pathogens such as Candida pelliculosa are increasingly reported. We report the case of a 6-month-old infant with cholestasis and persistent thrombocytopenia unresponsive to broad-spectrum antibiotics. Peripheral smear examination revealed budding yeast cells suggestive of fungemia, later confirmed as Candida pelliculosa by culture and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS). Intravenous fluconazole led to significant clinical and hematologic recovery. This case highlights the diagnostic utility of peripheral smear for early detection of rare fungal pathogens, particularly in resource-limited settings lacking rapid diagnostics. High clinical suspicion and timely antifungal therapy are critical for favorable outcomes in infantile candidemia.