Ann Surg Treat Res.  2015 Jan;88(1):48-51. 10.4174/astr.2015.88.1.48.

An unusual case of candidemia presenting as acute respiratory distress syndrome after a small bowel bezoar removal operation

• Mun YS
• Lee MS
• Park JS
• Lee JW
• Jung SY
• Yoon HJ
• Han HY

• KMID: 2167059
• DOI: http://doi.org/10.4174/astr.2015.88.1.48

Abstract

We report a rare case of sepsis with acute respiratory distress syndrome (ARDS) caused by Candida parapsilosis and Candida famata after a small bowel bezoar operation. The patient was successfully treated with intensive care including mechanical ventilation and systemic antifungal therapy. A strong association was observed between the intestinal obstruction caused by the bezoar and candidemia presenting as ARDS. This is the first case in which candidemia has led to ARDS after a bezoar removal operation in a patient who was neither immunocompromised nor self-administering an illicit intravenous drug.

Keyword

Candidemia; Small bowel bezoar; Acute respiratory distress syndrome

MeSH Terms

Bezoars*
Candida
Candidemia*
Humans
Critical Care
Intestinal Obstruction
Respiration, Artificial
Respiratory Distress Syndrome, Adult*
Sepsis

Figure

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  Fig. 1 Abdomen CT shows a dilated small bowel loop and a mass (arrow) measuring 5.5 cm.

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  Fig. 2 A bezoar impacted in the ileum. The bezoar was a 6.0 × 3.5-cm-sized, ovoid shape.

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  Fig. 3 (A) Chest x-ray on postoperative day 7. Diffuse ground glass opacity in the both upper lobe of the lung. (B) Chest x-ray on the seventh day of antifungal treatment. Disappearance of diffuse ground glass opacity in the both upper lobe of the lung.

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