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Updated: Sep 19, 2025
An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract
Published on: July 1, 2020
Post-Surgical Abdominal Myonecrosis: The Unusual Role of Candida albicans
Brian Musch1, Rachel A Daley2, Alyssa McMandon2
1Surgery, Grand Strand Medical Center, Myrtle Beach, USA.
Abstract:
Necrotizing myonecrosis is a life-threatening infection of the skeletal muscle and soft tissues, predominantly caused by bacteria such as Staphylococcus aureus and Group A Streptococcus. In rare cases, fungal organisms, particularly Candida albicans, have been identified as the sole causative agent in these infections. We present a rare case of a 77-year-old female patient who underwent an elective hysterectomy that was complicated by an iatrogenic injury to her small bowel, which was missed in the preliminary surgery. Postoperatively, she developed signs of peritonitis and greenish-brown drainage from her incision site. Exploratory laparotomy confirmed small bowel perforation. Subsequently, she developed abdominal sepsis and necrotizing myonecrosis involving the anterior abdominal wall musculature. Empiric treatment with broad-spectrum antibiotics was initiated. Intraoperative cultures revealed isolated Candida albicans, prompting a shift in management to antifungal therapy and multiple surgical debridements of the anterior musculature.
Insights
Necrotizing myonecrosis, a severe soft tissue infection, can rarely be caused solely by Candida albicans. This case highlights a fungal infection following abdominal surgery complications.
Area of Science:
- Infectious Diseases
- Surgical Pathology
Background:
- Necrotizing myonecrosis is a severe soft tissue infection often caused by bacteria.
- Fungal infections, particularly Candida albicans, are rare causes of necrotizing myonecrosis.
Observation:
- A 77-year-old female developed necrotizing myonecrosis of the abdominal wall post-hysterectomy with a missed small bowel perforation.
- Initial symptoms included peritonitis and wound drainage, progressing to abdominal sepsis.
Findings:
- Intraoperative cultures identified Candida albicans as the sole causative agent.
- The patient was transitioned from broad-spectrum antibiotics to antifungal therapy.
Implications:
- This case underscores the importance of considering fungal pathogens in necrotizing myonecrosis, especially post-abdominal surgery.
- Aggressive surgical debridement and targeted antifungal treatment are crucial for managing such rare infections.
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