Gastric perforation caused by Candida infection：Report of a case

DOI 機関リポジトリ HANDLE
  • TANAKA Takayuki
    Department of Surgery, Nagasaki Prefecture Shimabara Hospital Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • MINAMI Shigeki
    Department of Surgery, Nagasaki Prefecture Shimabara Hospital Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • TSUTSUMI Ryuji
    Department of Surgery, Nagasaki Prefecture Shimabara Hospital
  • AZUMA Takashi
    Department of Surgery, Nagasaki Prefecture Shimabara Hospital
  • MATSUO Shigetoshi
    Department of Surgery, Nagasaki Prefecture Shimabara Hospital
  • HAYASHI Tomayoshi
    Department of Pathology, Nagasaki University Hospital
  • EGUCHI Susumu
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • KANEMATSU Takashi
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences

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An 89-year-old female was admitted to our hospital because of fever and abdominal pain. The patient had used an antihypertensive agent, but had not used either antibiotics, steroids, or potent antacids. An abdominal CT scan revealed free air and ascites. An emergency operation was performed for acute peritonitis caused by a gastrointestinal perforation. A perforated ulcer was observed at the posterior wall of the gastric body. A distal gastrectomy with intraperitoneal drainage and a Billroth II reconstruction was performed. A histological examination demonstrated a perforated ulcer surrounded by Candida infection. The patient developed an abscess in the abdominal cavity, but was discharged on the 52nd postoperative day. Although gastrointestinal Candida infection is commonly seen in immunocompromised host with diabetics or malignant diseases, habitual use of strong antacids can also cause severe Candida infection of the stomach in healthy persons. In this case, it was thus concluded that there may have been a decrease in immunity in this patient because of her advanced age 89 years old and malnutrition.

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