A Clinical Analysis of Gastric Candidiasis

Seo, Geom Seog; Kim, Jin Ah; Kim, Yong Sung; Yoo, Keyoung Hoon; Kim, Tae Hyeon; Choi, Suck Chei; Kim, Haak Chel; Nah, Yong Ho; Yun, Ki Jung

Abstract

BACKGROUND AND AIMS
Gastric candidiasis is an uncommon disorder. But in recent years this diagnosis has increased as a result of the greater use of broad-spectrum antibiotics, immunosuppressive and chemotherapeutic agents or of the use of drugs that reduce the gastric acid production, such as H2 receptor antagonists. Our aim of the present study was to investigate clinical characteristics of gastric candidiasis including endoscopic findings and histopathology. METHODS: We reviewed 28 cases of gastric candidiasis who have under-went endoscopic biopsy at Wonkwang University Hospital from January 1995 to eptember 1996. RESULTS: 1) The prevalence rate of gastric candidiasis was 0.8% (28/3400). 2) In benign and malignant gastric ulcer patients, occurrence of other clinical findings were cardio-vascular disease in 5 cases, diabetes mellitus in 3 cases, hepatobiliary disease in 5 cases, bronchopulmonary disease in 10 cases, renal disease in 1 case, immunosuppressive therapy in 1 case, peptic ulcer therapy in 4 cases, and nongastric neoplasm in 1 case. 3) Locations of benign and malignant gastric ulcers in patients with candidial infection were prepyloric area in 8 cases, angle in 7 cases, body in 11 cases, cardia and fundus in 2 cases. 4) Sizes of ulcer cases were almost > or =2 cm in benign ulcer (76.5%), all cases were > or =3 cm in malignant ulcer. 5) According to endoscopic criteria, thrush type were in 22 cases, ulcerated type in 6 cases and depth of candidial infection in ulcer base were suppurative type in 18 cases, fibrinoid type in 10 cases. 6) After 6 weeks of therapy, endoscopic and clinical cure occurred in 60% (3/5) of patients treated by H2 blocker, antacid, and occurred in 100% (5/5) of patients treated by H2 blocker, antacid and antifungal agent. CONCLUSIONS: These results suggest that gastric candidiasis has a large and dirty ulcer base, white or green-white membrane and spread over inflammed area.