Candidiasis of the extrahepatic biliary tract

A case of isolated candidal cholecystitis and cholangitis involving the extrahepatic biliary tract is described. A 72-year-old man developed fever and unexplained jaundice following repair of a descending thoracic aortic aneurysm. Candidemia was noted, and therapy with amphotericin B was instituted. The patient died of a cerebral infarct, and at autopsy the gallbladder was noted to be partly necrotic and contained blastospores and pseudohyphae of Candida albicans. The common bile duct was markedly stenosed and chronically inflamed. Candidiasis of the extrahepatic biliary tract with or without systemic involvement is rare; to our knowledge, only nine cases have been reported. Although this condition represents a diagnostic challenge, the treatment is highly effective with most patients who were described having recovered.