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Intraluminal pancreatic candidiasis presenting as recurrent pancreatitis

R T Chung1, R H Schapiro, A L Warshaw

  • 1Gastrointestinal Unit, Massachusetts General Hospital, Boston.

Gastroenterology
|May 1, 1993
PubMed

Insights

A rare case of recurrent pancreatitis in an elderly man was linked to Candida albicans fungus balls in the pancreatic duct. Treatment with surgery and antifungal medication led to a sustained recovery, suggesting a role for fungal superinfection in chronic pancreatitis.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Recurrent acute pancreatitis can significantly impact patient quality of life.
  • Chronic pancreatitis may predispose pancreatic ducts to secondary infections.
  • Endoscopic retrograde pancreatography (ERP) is a key diagnostic tool for pancreatic duct abnormalities.

Observation:

  • An 88-year-old male presented with frequent acute pancreatitis episodes.
  • ERP revealed ductal changes consistent with chronic pancreatitis and intraluminal filling defects.
  • Microscopic examination identified these defects as fungus balls composed of Candida albicans.

Findings:

  • Successful treatment involved longitudinal pancreaticojejunostomy and oral fluconazole.
  • The patient remained recurrence-free for 30 months post-treatment.
  • Candida superinfection was identified as a potential cause of recurrent pancreatitis in this case.

Implications:

  • Candida superinfection may be an underrecognized cause of symptomatic recurrent pancreatitis.
  • Chronic dilation of pancreatic ducts could facilitate fungal colonization.
  • This case highlights the importance of considering fungal infections in complex pancreatitis cases.

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