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[Ascitic peritonitis due to Candida albicans]
A Suárez1, L Otero, C A Navascués
1Sección de Aparato Digestivo, Hospital de Cabueñes, Gijón.
Abstract:
We report a case of spontaneous peritonitis due to Candida albicans, in a diabetic patient with alcoholic liver cirrhosis, ascites, gastrointestinal bleeding from esophageal varices, sepsis, renal failure and encephalopathy. These factors, added to prolonged antibiotic therapy and instrumental manipulations, could have resulted in the colonization by Candida, usually described in secondary peritonitis, but perhaps underdiagnosed in cirrhotic patients with spontaneous peritonitis and severe multiorgan failure.
Insights
A diabetic patient with severe liver cirrhosis developed spontaneous fungal peritonitis caused by Candida albicans. This rare complication may be underdiagnosed in critically ill patients with advanced cirrhosis and organ failure.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Gastroenterology
Background:
- Spontaneous bacterial peritonitis (SBP) is a common complication in patients with decompensated cirrhosis.
- Fungal peritonitis is rare and typically associated with secondary causes, such as intra-abdominal procedures or infections.
Observation:
- A case of spontaneous peritonitis due to Candida albicans in a diabetic patient with alcoholic liver cirrhosis was observed.
- The patient presented with ascites, gastrointestinal bleeding, sepsis, renal failure, and encephalopathy.
Findings:
- The patient's complex medical history, including prolonged antibiotic use and instrumental manipulations, may have contributed to Candida colonization.
- This case suggests that Candida peritonitis, though uncommon, might be an underdiagnosed cause of spontaneous peritonitis in cirrhotic patients with severe multiorgan failure.
Implications:
- Clinicians should consider fungal peritonitis in cirrhotic patients with severe illness and refractory ascites, especially if standard bacterial cultures are negative.
- Early diagnosis and appropriate antifungal treatment are crucial for improving outcomes in these critically ill patients.
- Further research is needed to understand the incidence and risk factors for fungal peritonitis in cirrhosis.