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Updated: Aug 1, 2026

Technical Detail for Robot Assisted Pancreaticoduodenectomy
Published on: September 28, 2019
[Pancreatic pseudocyst, Torulopsis glabrata primary infection. Report of a case]
H León-Trueba1, J A Del Pozzo, A Bolio-Galvis
1Departamento de Cirugía General, Hospital Central Sur de Alta Especialidad, PEMEX.
Background:
T. glabrata is a saprophyte fungus that has been considered in the past years to be a pathologic agent in the pancreatic pseudocyst. Only three cases have been reported in the world literature.
Objective:
To present a new case of a patient with pancreatic pseudocyst whose primary cause of infection and sepsis was Torulopsis glabrata and to analyze the possible factors that produced the infection. In the same manner, a review of the cases on literature to date was conducted.
Case Report:
We present the clinical evolution of a post surgical patient with conventional cholecystectomy with biliary duct exploration and biliary duct derivation secondary to choledocholithiasis. This patient developed acute pancreatitis days after an endoscopic retrograde cholangiopancreatography was carried out. The patient received wide-range antibiotics and total parenteral nutrition (TPN). Later, the patient's case was complicated with pancreatic pseudocyst that was act diagnosed and managed initially with antifungus therapy due to an asymptomatic stage and a late report for T. glabrata.
Conclusions:
Pancreatobiliary duct instrumentation, in the same manner, prolonged therapy with wide-spectrum antibiotics and with TPN an with the means that had associated as risk factors for T. glabrata infection. Therefore, this fungus could have changed its biologic behavior from commensal to pathogenic. A potentially pathogenic agent in patients receiving this type of therapy and who have pancreatic pseudocyst must be considered to recognize these in the initial stages and begin therapy.
Insights
Torulopsis glabrata can cause pancreatic pseudocysts and sepsis, particularly in patients undergoing biliary procedures and receiving broad-spectrum antibiotics or TPN. Early recognition and antifungal therapy are crucial for managing this opportunistic fungal infection.
Area of Science:
- Medical Mycology
- Gastroenterology
- Infectious Diseases
Background:
- Candida glabrata (formerly Torulopsis glabrata) is a yeast that can act as a pathogen in pancreatic pseudocysts.
- Only three cases of T. glabrata-associated pancreatic pseudocysts have been reported globally.
Observation:
- A post-surgical patient developed a pancreatic pseudocyst after cholecystectomy and ERCP.
- The patient received broad-spectrum antibiotics and total parenteral nutrition (TPN), later developing T. glabrata infection and sepsis.
- Diagnosis was delayed due to an asymptomatic presentation and late identification of T. glabrata.
Findings:
- Pancreatobiliary duct instrumentation, prolonged broad-spectrum antibiotic therapy, and TPN were identified as significant risk factors for T. glabrata infection.
- These factors may promote the transition of T. glabrata from a commensal to a pathogenic organism.
- The case highlights the potential for T. glabrata to cause severe infections in immunocompromised or debilitated patients.
Implications:
- T. glabrata should be considered a potential pathogen in patients with pancreatic pseudocysts, especially those with risk factors like recent instrumentation or prolonged TPN.
- Early diagnosis and initiation of antifungal therapy are critical for improving patient outcomes.
- Further research is needed to understand the pathogenesis and optimal management of T. glabrata in pancreatic infections.
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