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Necrotizing Candida enterocolitis in AIDS: CT features

E J Balthazar1, J Stern

  • 1Department of Radiology, New York University Tisch Medical Center, NY 10016.

Journal of Computer Assisted Tomography
|March 1, 1994
PubMed
Summary
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A rare case of necrotizing enterocolitis caused by invasive candidiasis in patients with acquired immunodeficiency syndrome is presented. This finding highlights a severe complication in immunocompromised individuals.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Immunology

Background:

  • Acquired immunodeficiency syndrome (AIDS) compromises the immune system, increasing susceptibility to opportunistic infections.
  • Necrotizing enterocolitis (NEC) is a serious gastrointestinal condition, typically affecting premature infants.
  • Invasive candidiasis is a systemic fungal infection that can occur in immunocompromised patients.

Observation:

  • Computed tomography (CT) revealed small bowel dilation, dense intestinal contents, and ileal pneumatosis intestinalis.
  • Air was observed in the intrahepatic portal vein branches, suggesting a severe complication.
  • Pathology of the resected specimen showed mucosal ulcerations and transmural necrosis in the distal ileum and right colon.

Findings:

  • The case demonstrates necrotizing enterocolitis secondary to invasive candidiasis in an adult with acquired immunodeficiency syndrome.

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  • Fungal invasion by Candida species was identified as the direct cause of the intestinal necrosis.
  • This represents an unusual presentation of invasive candidiasis in the gastrointestinal tract.
  • Implications:

    • This case underscores the importance of considering invasive fungal infections in immunocompromised patients presenting with severe abdominal symptoms.
    • Early diagnosis and appropriate antifungal therapy are crucial for managing such life-threatening conditions.
    • Further research may elucidate the specific mechanisms and risk factors for gastrointestinal candidiasis leading to NEC in AIDS patients.