Large bowel Candidiasis with diarrhea

Hippokratia 2000, 4(4):152-156

F. Karasavvidou, G. Georgiou, D. Kirmizis, N. Flaris, E. Bibasi, E. Alexopoulos, M. Leontsini


Candidiasis is the most frequently encouniered fungal infection in patients with cancer and immunocompromised patients. Gastrointestinal candidiasis is being recognized more commonly in recent years. Esophagus and stomach are the most frequently affected organs. Large bowel infection and diarrhea due to Candida overgrowth is uncommon.We report a case of a 70-year-old, immunocompromised woman, with chronic renal failure and nephrotic syndrome due to membranous glomerulonephritis. During her hospitalization, respiratory tract inflammation was diagnosed and antibiotic therapy was given. Ten days after her hospitalization, although she was still on antibiotic therapy, she developed watery diarrhea. Colonoscopy was performed and biopsies were taken. Candida albicans was isolated in stool cultures. Colonoscopy showed edematous mucosa, segmental ulcers and haemorrhagic areas. Histological examination of biopsies showed extensive ulceration of the mucosa with fibrin exudate and haemorrhage. Within the fibrin exudates fungal parasites were seen. The patient died of sepsis. Autopsy was not performed.In suspected cases of fungal colitis in immunocompromised patients the diagnosis should be established by biopsy.