Systemic Infection by the Gasric Candidiasis

ABSTRACT

Candida albicans is a saprophytic organism that frequently resides in the mouth, skin, gastrointestinal and vaginal mucosa. It is also an opportunistic pathogen in immune compromised individuals, diabetics, alcoholics, and where drugs have reduced gastric acid production, and in debilitated subjects treated with antibiotics, steroids, and immunosuppressive or antineoplastic drugs. Although the most common site of gastrointestinal involvement is the esophagus, gastric candidiais may occur in immunosuppressed patients, but is rarely apparent in healthy individuals. Systemic infection by gastric candidiasis is extremely rare. A case of gastric candidiasis, presenting with sepsis, was experienced in a 46-year-old male with diabetes mellitus. He underwent orthopedic surgery because of an intertrochanteric fracture of his femur. On day 6 of the postoperative period, the patient began suffering from an intermittent fever, epigastric pain, and vomiting. Day by day the patient's condition became debilitating and sepsis developed. An endoscopic examination revealed multiple whitish, or central necrotic, plaques in the body and antrum of the stomach. An endoscopic biopsy revealed budding yeast and pseudohyphae infiltrating through the ulcerated gastric wall. After the patient was treated with the fluconazole alternative, liposomal amphotericin B, the patient's condition and endoscopic finding improved. Here, a case of gastric candidiasis presenting with sepsis, in reported along with a review of the corresponding literature.