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Bowel perforation with candidiasis.

D Schlossberg, P M Devig, H Travers

    JAMA
    |December 5, 1977
    PubMed
    Summary
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    Invasive candidiasis caused spontaneous jejunal perforations in a patient. Antibody evidence confirmed the fungal infection, highlighting a rare presentation of Candida albicans.

    Area of Science:

    • Gastroenterology
    • Mycology
    • Infectious Diseases

    Background:

    • Spontaneous gastrointestinal perforations are rare, especially in otherwise healthy individuals.
    • Invasive fungal infections, particularly candidiasis, can present with diverse and severe manifestations.

    Observation:

    • Multiple jejunal perforations were observed in a patient with no significant prior medical history.
    • Microscopic examination revealed Candida albicans yeasts and pseudohyphae within the necrotic mucosal tissue.
    • Fungal elements were also identified in peritoneal fluid samples.

    Findings:

    • Culture of Candida albicans from perforation biopsy and peritoneal fluid confirmed fungal presence.
    • Serological testing showed precipitating and agglutinating antibodies against Candida, supporting an invasive infection.

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  • The findings indicate invasive candidiasis as the etiology of the jejunal perforations.

    • Implications:

    • This case highlights an unusual and severe presentation of invasive candidiasis.
    • It underscores the importance of considering fungal infections in unexplained gastrointestinal perforations.
    • Early diagnosis and treatment of invasive candidiasis are crucial for patient outcomes.