A case of candida fungemia in acute pancreatitis and hepatitis associated with typhoid fever / 대한내과학회지

ABSTRACT

Typhoid fever is a bacteremic disease and many organs, including intestine, liver, bone, lung, thyroid, kidney, spleen, heart and pancreas may be invaded by the organism. Acute pancreatitis associated with typhoid fever sometimes needs prolonged total parenteral hyperalimentation and antibiotic treatment. Systemic Candida infections are usually encountered as opportunistic infections in a setting of immunologic depression. The authors report a case of Candida parapsilosis fungemia associated parenteral nutrition in acute pancreatitis associated with typhoid fever. A 17 year-old man was transfered to Pusan national university hospital on May 4th, 1998 under diagnosis of salmonella sepsis. High fever, nausea, vomiting and diarrhea developed 10 days before entery. On admission, serum amylase, lipase and transaminase showed elevation. The patient was treated with antibiotics(ceftriaxon) and total parenteral hyperalimentation was done under diagnosis of acute pancreatitis and hepatitis associated with typhoid fever. On 3rd hospital day, body temperature returned to normal but abdominal pain, nausea and vomiting continued. On 18th hospital day, high fever recurred and ceftriaxon was re-administered. Three days later, body temperature returned to normal. On 25th hospital days, culture of blood and catheter tip was positive for C. parapsilosis. On 27th hospital days, sudden onset high fever, pnumonic infiltration, confusion, hypotension, oliguria and azotemia developed. On 34th hospital day, sudden onset ventricular fibillation developed. On 35th hospital day, the patients died. We report a case of candida fungemia in acute pancreatitis and hepatitis associated with typhoid fever.