A Case of Gastric Candidiasis Presented with Massive Gastric Bleeding / 대한소화기내시경학회지

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, alcoholics, and debilitated subjects treated with antibiotics, steroids, or antineoplastic drugs. Although the most common site of gastrointestinal involvement is the esophagus, gastric candidiasis may occur in immune suppressed patients and is rarely apparent in healthy individuals. Symptoms are nonspecific; indigestion, abdominal pain, fever and weight loss have been described. The diagnosis can usually be established by visualizing yeast and/or mycelial forms in endoscopic biopsy or in mucosal brushings of the lesions. A case of gastric candidiasis presented with bleeding was experienced in a 69-year-old female with chronic renal failure due to diabetic nephropathy. She underwent orthopedic surgery because of intertrochanteric fracture of her femur. On the 6th day of the postoperative period, the patient began suffering from a large amount of melena. Endoscopic findings revealed multiple whitish or central necrotic plaques in the body and antrum of the stomach. Endoscopic biopsy revealed budding yeast and pseudohyphae infiltrating through the ulcerated stomach wall. After the patient was treated with mycostatin for 7 days, endoscopic and pathologic findings did not show any evidence of the candidiasis. The case is herein reported of gastric candidiasis presented with gastric bleeding, along with a review of corresponding literature.