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Fatal esophageal perforation caused by invasive candidiasis

Michael Gock1, Markus Schäfer, Aurel Perren

  • 1Department of Visceral and Transplantation Surgery, and Pathology, University of Zürich, Zürich, Switzerland.

The Annals of Thoracic Surgery
|August 27, 2005
PubMed

Insights

Transmural Candida infection is a rare cause of esophageal perforation. This case highlights the severe outcomes, including death from septic shock, even with aggressive treatment.

Area of Science:

  • Gastroenterology
  • Mycology
  • Pathology

Background:

  • Esophageal perforations typically result from instrumental lesions, spontaneous rupture, or trauma.
  • Transmural fungal infections are an exceptionally uncommon etiology for esophageal perforation.
  • Candida species are frequently found in the normal esophageal flora.

Observation:

  • A case report details a fatal esophageal perforation in a 76-year-old woman.
  • The perforation was attributed to a transmural Candida infection.
  • The patient succumbed to septic shock and multiorgan failure.

Findings:

  • Despite surgical intervention (esophageal resection) and systemic antifungal treatment, the patient's outcome was fatal.
  • This case underscores the potential severity of transmural Candida infections in the esophagus.
  • The study discusses pathogenetic mechanisms and therapeutic approaches for this rare condition.

Implications:

  • Highlights the critical need for early recognition and aggressive management of rare esophageal perforation causes.
  • Emphasizes the challenges in treating invasive fungal infections of the esophagus.
  • Contributes to understanding the clinical presentation and outcomes of transmural Candida esophagitis.

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