[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.

Abstract

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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