Candida infections of the abdomen and thorax
- Carol A Kauffman, MD
Carol A Kauffman, MD
- Section Editor — Fungal Infections
- Professor of Internal Medicine
- University of Michigan Medical School
- Veterans Affairs Ann Arbor Healthcare System
The clinical manifestations of infection with Candida species range from local mucous membrane infections to widespread dissemination with multisystem organ failure. Although Candida are considered normal flora in the gastrointestinal and genitourinary tracts of humans, they have the propensity to invade and cause disease when an imbalance is created in the ecologic niche in which these organisms usually exist. (See "Biology of Candida infections".)
The immune response of the host is an important determinant of the type of infection caused by Candida. The different Candida species generally are capable of producing all of the clinical syndromes, although infection with Candida albicans is the most common. The major importance of identifying the infecting organism is that some species are more resistant to the azole antifungal agents than others. (See "Treatment of candidemia and invasive candidiasis in adults".)
This topic will review the manifestations of Candida infection involving the abdomen and thorax. Other manifestations of Candida infections are discussed separately. (See "Overview of Candida infections" and "Clinical manifestations and diagnosis of candidemia and invasive candidiasis in adults" and "Chronic disseminated candidiasis (hepatosplenic candidiasis)" and "Candida infections in children: An overview".)
PERITONITIS AND INTRAABDOMINAL INFECTIONS
Candida species frequently contribute to polymicrobial infections that occur following gut perforation, anastomotic leaks after bowel surgery, and acute necrotizing pancreatitis [1-8]. Discrete abscesses with or without peritonitis can occur.
Candida peritonitis can also complicate continuous peritoneal dialysis in patients with end-stage renal disease. This disorder is discussed elsewhere. (See "Fungal peritonitis in continuous peritoneal dialysis".)
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