Chronic mesenteric ischaemia masked by candida esophagitis in a renal transplant patient

Area of Science:

• Gastroenterology
• Vascular Surgery
• Infectious Diseases

Background:

• Chronic mesenteric ischemia (CMI) presents non-specifically, complicating diagnosis.
• Immunosuppressed patients are prone to infections that can mimic or mask CMI.
• Accurate diagnosis of CMI is crucial due to its severe morbidity and mortality.

Observation:

• A patient presented with symptoms initially suggestive of candida esophagitis.
• The patient was immunosuppressed, increasing the risk of gastrointestinal infections.
• Worsening leukocytosis persisted despite initial treatment for presumed infection.

Findings:

• Re-evaluation revealed a superior mesenteric artery thrombus as the cause of mesenteric ischemia.
• The clinical presentation mimicked infectious esophagitis, delaying CMI diagnosis.
• Urgent surgical intervention was necessary for the patient's mesenteric ischemia.

Implications:

• This case underscores the importance of considering CMI in non-specific abdominal presentations, especially in immunosuppressed individuals.
• Diagnostic challenges in CMI require a high index of suspicion and thorough investigation.
• Timely surgical management is critical for favorable outcomes in acute mesenteric ischemia.