Gastric Perforation due to Candida Infection in Association with Prolonged Proton Pump Inhibitor Use: A Report of Two Cases
Fungus as a cause of gastric perforation is very rare. Very low pH of stomach usually does not support fungal growth. It is usually associated with immunocompromised state or is seen in debilitated patients like patients receiving steroid therapy, patients with Diabetes Mellitus (DM) and Human Imm...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-11-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/15631/50725_CE[Ra1]_F(SHU)_PF1(AG_SS)_PN(KM).pdf |
| Summary: | Fungus as a cause of gastric perforation is very rare. Very low pH of stomach usually does not support fungal growth. It is usually
associated with immunocompromised state or is seen in debilitated patients like patients receiving steroid therapy, patients with
Diabetes Mellitus (DM) and Human Immunodeficiency Virus (HIV) infection, patients undergoing transplant. Prolonged use of strong
antacids can also be a predisposing factor for gastric fungal infection; although this theory is controversial, authors could find few
studies which were similar to present study. Here, authors are reporting two cases of gastric perforation leading to peritonitis,
in otherwise healthy individuals due to prolonged Proton Pump Inhibitors (PPIs) use, due to Candida infection, in the following
case report. Both patients (48-year-old male and 65-year-old female) had history of chronic PPI use, had gastric perforation and
underwent exploratory laparotomy. On histopathological examination of perforation edge biopsy yeast forms and few pseudohyphae
of Candida species were identified. Postoperatively one of the patients survived with systemic antifungal, antibiotic therapy along
with replacement of PPI with histamine H2 receptor blockers. The other patient could not survive and died postoperatively due to
septicaemia. Fungal aetiology in gastric perforation should prompt further evaluation to look for underlying cause. This case report
highlights the effects of unjust and over use of strong antacids for prolonged period. |
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| ISSN: | 2249-782X 0973-709X |