Korean J Med.  2000 Apr;58(4):462-465.

A case of candida fungemia in acute pancreatitis and hepatitis associated with typhoid fever

• Kwak IS
• Lee SB
• Chung JS
• Cho GJ
• Rha HY

Abstract

Typhoid fever is a bacteremic disease and many organs, including intestine, liver, bone, lung, thyroid, kidney, spleen, heart and pancreas may be invaded by the organism. Acute pancreatitis associated with typhoid fever sometimes needs prolonged total parenteral hyperalimentation and antibiotic treatment. Systemic Candida infections are usually encountered as opportunistic infections in a setting of immunologic depression. The authors report a case of Candida parapsilosis fungemia associated parenteral nutrition in acute pancreatitis associated with typhoid fever. A 17 year-old man was transfered to Pusan national university hospital on May 4th, 1998 under diagnosis of salmonella sepsis. High fever, nausea, vomiting and diarrhea developed 10 days before entery. On admission, serum amylase, lipase and transaminase showed elevation. The patient was treated with antibiotics(ceftriaxon) and total parenteral hyperalimentation was done under diagnosis of acute pancreatitis and hepatitis associated with typhoid fever. On 3rd hospital day, body temperature returned to normal but abdominal pain, nausea and vomiting continued. On 18th hospital day, high fever recurred and ceftriaxon was re-administered. Three days later, body temperature returned to normal. On 25th hospital days, culture of blood and catheter tip was positive for C. parapsilosis. On 27th hospital days, sudden onset high fever, pnumonic infiltration, confusion, hypotension, oliguria and azotemia developed. On 34th hospital day, sudden onset ventricular fibillation developed. On 35th hospital day, the patients died. We report a case of candida fungemia in acute pancreatitis and hepatitis associated with typhoid fever.

Keyword

Pancreatitis; Typhoid fever; Hyperalimentation; Candida parapsilosis

MeSH Terms

Abdominal Pain
Adolescent
Amylases
Azotemia
Body Temperature
Busan
Candida*
Catheters
Ceftriaxone
Depression
Diagnosis
Diarrhea
Fever
Fungemia*
Heart
Hepatitis*
Humans
Hypotension
Intestines
Kidney
Lipase
Liver
Lung
Nausea
Oliguria
Opportunistic Infections
Pancreas
Pancreatitis*
Parenteral Nutrition
Parenteral Nutrition, Total
Salmonella
Sepsis
Spleen
Thyroid Gland
Typhoid Fever*
Vomiting
Amylases
Ceftriaxone
Lipase