A rare case of acute pancreatitis caused by Candida Albicans

• Published in: Clinical journal of gastroenterology Vol. 12; no. 1; pp. 82 - 87
• Main Authors: Tange, Kazuhiro, Yokota, Tomoyuki, Sunago, Kotaro, Aono, Michiko, Ochi, Hironori, Takechi, Shunji, Mashiba, Toshie, Hida, Akira Iino, Oshiro, Yumi, Joko, Kouji, Kumagi, Teru, Hiasa, Yoichi
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.02.2019
• Subjects: Abdominal Surgery; Case Report; Colorectal Surgery; Gastroenterology; Hepatology; Medicine; Medicine & Public Health; Surgical Oncology; Fungus ball; Acute pancreatitis; Candida Albicans
• DOI: 10.1007/s12328-018-0896-7
• ISSN: 1865-7257

We experienced a rare case of acute pancreatitis caused by Candida infection. A 52-year-old man was admitted to our hospital with a chief complaint of abdominal pain. Blood tests revealed high amylase and hepatobiliary enzyme abnormalities, and the patient was hospitalized for acute pancreatitis. Abdominal computed tomography showed a 15-mm space-occupying lesion at the parenchyma of the pancreatic head. Endoscopic retrograde cholangiopancreatography was performed after conservative treatment, which revealed a cystic lesion with a suspected solid component inside involving both lower bile duct and pancreatic duct. Cytology of collected bile and pancreatic juice revealed innumerous hyphae and spores morphologically consistent with Candida spp., as did endoscopic ultrasound-guided fine needle aspiration biopsy of the tumor site. Empiric therapy with oral fluconazole resulted in reduction of the space-occupying lesion 3 months after discharge. However, acute pancreatitis recurred about 1 year and 6 months after discharge. After conservative treatment was carried out again, the same lesion was fenestrated by endoscopic sphincteroplasty, and its internal solid components were resected using a basket catheter. Pathological analysis confirmed the presence of fungus balls and degenerated substances. Candida Albicans was identified by fungal culture examination. After the excretion of the fungus balls, pancreatitis did not recur thereafter during outpatient follow-up.