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[Complicated course of oesophageal perforations because of fungal infections]

T Jungbluth1, R Bouchard, P Kujath

  • 1Klinik für Chirurgie des Universitätsklinikums Schleswig-Holstein, Campus Lübeck, D-23538 Lübeck, Germany. jungbluth-th@gmx.de

Mycoses
|April 14, 2005
PubMed

Insights

Oesophageal perforations have high mortality, often due to sepsis. Fungal infections (mycoses) increase mortality risk, necessitating microbiological monitoring and targeted antifungal therapy alongside surgical intervention.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Pathology

Context:

  • Oesophageal perforations present a significant clinical challenge with high mortality rates (7-49%).
  • Septic complications like mediastinitis and pneumonia are primary drivers of mortality in these patients.
  • Fungal infections (mycoses) are frequently observed in patients with oesophageal perforations.

Purpose:

  • To investigate the role of mycoses in oesophageal perforations.
  • To analyze the impact of fungal infections on mortality rates.
  • To evaluate current management strategies for oesophageal perforations complicated by mycoses.

Summary:

  • A study analyzing patients from 1986-2003 found a 28% mortality rate, with septic complications being a major cause.
  • Mycoses were detected in 28% of patients, and these cases exhibited a higher mortality rate of 50%.
  • Invasive Candida infection can directly cause oesophageal perforation, and fungi can disseminate to cause sepsis.

Impact:

  • Highlights the critical association between fungal infections and increased mortality in oesophageal perforations.
  • Emphasizes the importance of microbiological monitoring and timely antifungal therapy.
  • Underscores the necessity of surgical management, including drainage of adjacent compartments, for improved patient outcomes.

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