Oesophageal intramural pseudodiverticulosis presenting as non-resolving pneumonia: A sinister cause diagnosed by EUS-B-FNA.

We report a case of an oesophageal intramural pseudodiverticulosis leading to a mediastinal collection caused by Candida glabrata presenting as a non-resolving pneumonia and mimicking an oesophageal mass. The patient was a 60-year-old diabetic male who was referred from another hospital and presented with a history of low-grade fever and breathlessness. His computed tomography (CT) of the chest disclosed a mediastinal mass alongside the oesophagus with pleural collection. Endobronchial ultrasound scope was inserted through the oesophagus (EUS-B) and fine-needle aspirate was taken from the mass. The cultures of specimen from the mediastinum grew drug-resistant C. glabrata. The patient was managed with oral voriconazole along with oesophageal stenting after which he showed remarkable recovery. Repeat CT revealed a near-complete reduction of the mediastinal infection. The case highlights the need of a high degree of suspicion, right approach to diagnostic work-up and appropriate histopathological and microbiological examination of clinical specimens.