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Necrotizing Candida enterocolitis in AIDS: CT features
1Department of Radiology, New York University Tisch Medical Center, NY 10016.
Abstract:
An unusual case of necrotizing enterocolitis secondary to invasive candidiasis in acquired immunodeficiency syndrome is reported. Computed tomography showed significant small bowel dilatation, high density intestinal contents, extensive ileal pneumatosis intestinalis, and air in the intrahepatic branches of the portal vein. Mucosal ulcerations and extensive transmural necrosis associated with invasive candidiasis were detected in the distal ileum and right colon in the resected pathology specimen.
Insights
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.
- 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.