When life gives you limes… it gives you Candida: a case of lime-contaminated IV injection

We present a case of a 29-year-old male with a history of intravenous drug use, who developed candidemia after injecting crack cocaine mixed with lime juice. The patient initially presented with sepsis, and the preliminary blood cultures grew Candida krusei. Upon further investigation, the final blood culture report also grew Candida lusitaniae. He was started on Caspofungin and completed a 14-day antifungal course, with a favorable outcome. This case may represent a rare instance of polymicrobial nonalbicans candidemia linked to lime juice injection, unlike typical acidifier-associated infections, which usually involve a single organism. This case underscores the elevated risk of invasive polymicrobial fungal infections, particularly candidemia, in intravenous drug users who use lime juice as a solvent, highlighting the need for early diagnosis and prompt treatment.