Gastric Perforation due to Candida Infection in Association with Prolonged Proton Pump Inhibitor Use: A Report of Two Cases
Correspondence Address :
Dr. Shilpa Mishra,
Patkar Penthouse 25, Firuz Ara, Opposite Cooperage Garden, Nariman Point,
Mumbai, Maharashtra, India.
E-mail: mishra.sm012@gmail.com
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.
Gastric candidiasis, Peritonitis, Strong antacids
10.7860/JCDR/2021/50725.15631
Date of Submission: Jun 07, 2021
Date of Peer Review: Jul 31, 2021
Date of Acceptance: Oct 13, 2021
Date of Publishing: Nov 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? No
• For any images presented appropriate consent has been obtained from the subjects. No
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jun 08, 2021
• Manual Googling: Oct 08, 2021
• iThenticate Software: Oct 27, 2021 (17%)
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