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[Fungal infestation of gastroduodenal ulcers: incidence and significance (author's transl)]
Abstract:
In a prospective study of 132 cases of gastroduodenal ulcer, proven by endoscopic biopsy, there were 59 in which fungi were cultered (44.7%). There was no significant difference in incidence between gastric ulcer (46.2%) and duodenal ulcer (42.6%), or between benign and malignant gastric ulcer (47.2 and 42.1%, respectively). Most of the fungi were yeasts of the genus Candida and Torulopsis. The mycel phase was demonstrable only in the native or histological preparation (16.7% [native] and 10.6% [histological] positive findings). In all those cases in which pseudomycels were demonstrated the culture count was especially high (more than 20 colonies). In most of these there was an additional disease which may be associated with immunological insufficiency (e.g. diabetes, chronic alcoholism, malignoma). The presence of pseudomycelia or more than 20 colonies in the culture from gastroduodenal ulcers are thus less of a pointer as to whether the local lesion is benign or malignant than to a general weakening of the organism's defence mechanisms.
Insights
Fungi, primarily yeasts like Candida, were cultured in 44.7% of gastroduodenal ulcers. The presence of pseudomycelia or high fungal counts indicates weakened immune defenses, not ulcer malignancy.
Area of Science:
- Gastroenterology
- Mycology
- Pathology
Context:
- Gastroduodenal ulcers are common gastrointestinal conditions.
- Fungal infections can complicate various diseases.
- Endoscopic biopsy is a standard diagnostic tool for gastroduodenal ulcers.
Purpose:
- To investigate the incidence and significance of fungal cultures in gastroduodenal ulcers.
- To determine if fungal presence correlates with ulcer type (gastric vs. duodenal) or malignancy.
- To explore the association between fungal morphology (yeast vs. mycelial phase) and patient health status.
Summary:
- A prospective study of 132 gastroduodenal ulcers found fungi in 44.7% of cases.
- No significant difference in fungal incidence was observed between gastric and duodenal ulcers, or between benign and malignant gastric ulcers.
- The mycelial phase, often associated with high fungal counts (>20 colonies) and pseudomycelia, was linked to underlying conditions indicative of immunodeficiency, such as diabetes, alcoholism, and malignancy.
Impact:
- Fungal presence in gastroduodenal ulcers may serve as an indicator of compromised host immunity rather than a direct marker of ulcer malignancy.
- This finding suggests a potential role for assessing host immune status in patients with specific fungal findings in gastroduodenal ulcers.
- Further research could explore therapeutic implications for managing fungal colonization in immunocompromised patients with gastroduodenal ulcers.