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Published on: June 13, 2018
Fungal infection associated with gastroduodenal ulceration: endoscopic and pathologic appearances
Abstract:
Three patients with peptic ulcers diagnosed at upper gastrointestinal endoscopy are reported. All were seriously ill (2 debilitated alcoholics) and died soon afterwards. Fungi were recognized in the antemortem specimen of one of the two ulcers biopsied at the time of endoscopy and in the postmortem specimens of all. In two, demise appears to have been precipitated by erosion of the wall of a major artery by fungal invasion. Culture of the ulcer based as well as throat swabs and stool examination for mycelial and yeast forms of fungus in susceptible patients may allow a more accurate diagnosis to be made and therapy to be instituted.
Insights
Fungal infections complicated peptic ulcers in seriously ill patients, leading to fatal arterial erosion in two cases. Early fungal diagnosis through cultures may improve outcomes for susceptible individuals.
Area of Science:
- Medical Mycology
- Gastroenterology
- Pathology
Background:
- Peptic ulcers are a significant clinical concern, particularly in severely ill patients.
- Fungal infections can present as opportunistic complications in compromised individuals.
Observation:
- Three seriously ill patients with peptic ulcers were studied.
- Fungi were identified in ulcer biopsies and postmortem specimens.
- Two patients experienced fatal arterial hemorrhage due to fungal invasion of ulcer walls.
Findings:
- Fungal presence in peptic ulcers can be associated with severe morbidity and mortality.
- Invasive fungal infection can lead to catastrophic vascular erosion.
- Diagnosis of fungal elements in ulcer biopsies and other samples is crucial.
Implications:
- Early detection of fungal elements in peptic ulcers is vital for timely intervention.
- Diagnostic methods like fungal cultures from ulcer biopsies, throat swabs, and stool samples should be considered in susceptible patients.
- Improved diagnostic strategies may lead to better therapeutic outcomes and reduced mortality in fungal-associated peptic ulcer disease.
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