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Candida tropicalis pylephlebitis with persistent fungaemia in a 72-year-old lady with severe pancreatitis

Wouter Meersseman1

  • 1Department of General Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium. wouter.meersseman@uzleuven.be

Mycoses
|December 1, 2011
PubMed

Insights

Fungal pylephlebitis, a rare septic thrombophlebitis of the portal venous system, can complicate pancreatitis. This case highlights successful treatment with echinocandins, offering a potential therapeutic strategy for this severe condition.

Area of Science:

  • Medical Mycology
  • Vascular Medicine
  • Gastroenterology

Background:

  • Pylephlebitis is septic thrombophlebitis of the portal venous system.
  • It typically arises secondary to abdominal infection or inflammation.
  • Fungal causes are exceptionally rare, posing diagnostic and therapeutic challenges.

Observation:

  • A patient with pancreatitis developed fungal pylephlebitis.
  • The causative fungal pathogen was identified.
  • Clinical progression necessitated targeted antifungal therapy.

Findings:

  • Successful resolution of fungal pylephlebitis was achieved using echinocandins.
  • Echinocandins demonstrated efficacy in treating this rare complication.
  • The patient's pancreatitis course was complicated but ultimately managed.

Implications:

  • This case expands the known spectrum of pylephlebitis etiologies.
  • It underscores the importance of considering fungal infections in severe abdominal sepsis.
  • Echinocandins represent a viable treatment option for fungal pylephlebitis.

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