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Candida in Acute Pancreatitis

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Abstract

Purpose

A Candida infection of the pancreas, which previously was considered extremely unusual, has been increasingly reported in recent years. The present study was conducted with the aim of performing a cohort analysis of our patients with acute pancreatitis to find out the incidence, sites, and species of Candida involvement; and to evaluate the risk factors, severity, and course of illness of such patients.

Methods

A total of 335 patients with acute pancreatitis were investigated for a possible Candida infection of the pancreas from January 2000 to May 2003. The clinical records of all those patients who were positive for Candida spp. isolation from pancreatic tissue were analyzed. The clinical records of 32 more cases, randomly selected from the patients who were investigated for candidal pancreatitis but were negative for Candida spp., were also analyzed in order to compare their findings with those patients with a true Candida infection of the pancreas.

Results

A true or possible Candida infection was observed in 41 (12.2%) of those 335 patients and Candida tropicalis was the most common isolate (43.9%). Candida spp. were isolated from pancreatic necrotic tissue in 22 (6.6%) patients (true infection). A possible Candida infection (positive drain fluid effluents at least twice, without any Candida isolation from pre/per operative samples from pancreas) was seen in 19 (5.7%) patients. Candida was also isolated exclusively from the blood in another 19 patients with a clinical diagnosis of acute pancreatitis. A risk factor analysis showed that patients with severe injury to the pancreas, on prophylactic fluconazole, and after surgical intervention were significantly more prone to develop a Candida infection. Patients with a Candida superinfection also had a significantly increased hospital stay and higher mortality.

Conclusion

This study thus emphasizes the important role of Candida infection in patients with acute pancreatitis and demonstrates the need for early attention.

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References

  1. AS Bayer MJ Blumenkrantz JZ Montgomerie JE Galpin JN Coburn LB Gauze (1976) ArticleTitleCandida peritonitis; report of 22 cases and review of English literature Am J Med 62 832–40 Occurrence Handle10.1016/0002-9343(76)90407-1

    Article  Google Scholar 

  2. JS Solomkin AB Flohr PG Quie RL Simmons (1980) ArticleTitleThe role of Candida in intra-peritoneal infections Surgery 88 524–30 Occurrence Handle7423375 Occurrence Handle1:STN:280:DyaL3M%2FjsVSksg%3D%3D

    PubMed  CAS  Google Scholar 

  3. P Sandven H Qvist E Skorlund KE Giercksky InstitutionalAuthorNamethe NORGAS group and the Norwegian study group (2002) ArticleTitleSignificance of Candida recovered from intra-operative specimens in patients with intra-abdominal perforations Crit Care Med 30 541–7 Occurrence Handle11990912 Occurrence Handle10.1097/00003246-200203000-00008

    Article  PubMed  Google Scholar 

  4. A Hoerauf S Hammer B Muller-Myhsok H Rupprecht (1998) ArticleTitleIntra-abdominal Candida infection during acute necrotizing pancreatitis has a high prevalence and is associated with increased mortality Crit Care Med 26 2010–5 Occurrence Handle9875913 Occurrence Handle10.1097/00003246-199812000-00031 Occurrence Handle1:STN:280:DyaK1M%2FptFWnsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  5. M Grewe GG Tsiotos EL de-Leon MG Sarr (1999) ArticleTitleFungal infection in acute necrotising pancreatitis J Am Coll Surgeons 188 408–14 Occurrence Handle10.1016/S1072-7515(98)00334-2 Occurrence Handle1:STN:280:DyaK1M3htVWjsg%3D%3D

    Article  CAS  Google Scholar 

  6. JJD Waele D Vogelaers S Blot F Colardyn (2003) ArticleTitleFungal infections in patients with severe acute pancreatitis and the use of prophylactic therapy Clin Infect Dis 37 208–13 Occurrence Handle12856213 Occurrence Handle10.1086/375603

    Article  PubMed  Google Scholar 

  7. T Calandra O Marchetti (2004) ArticleTitleClinical trials of anti-fungal prophylaxis among patients undergoing surgery Clin Infect Dis 39 IssueIDsuppl 4 S185–92 Occurrence Handle15546116 Occurrence Handle10.1086/421955 Occurrence Handle1:CAS:528:DC%2BD2cXpvFahsr8%3D

    Article  PubMed  CAS  Google Scholar 

  8. T Aloia J Solomkin AS Fink MS Nussbaum S Bjornson RH Bell L Sewak DW McFadden (1994) ArticleTitleCandida in pancreatic infection: a clinical experience Am Surg 60 793–6 Occurrence Handle7944045 Occurrence Handle1:STN:280:DyaK2M%2FjtVKmsQ%3D%3D

    PubMed  CAS  Google Scholar 

  9. P Keiser S Keay (1992) ArticleTitleCandidal pancreatic abscesses: report of two cases and review Clin Infect Dis 14 884–8 Occurrence Handle1576283 Occurrence Handle1:STN:280:DyaK383ksl2rug%3D%3D

    PubMed  CAS  Google Scholar 

  10. R Isenmann M Schwarz B Rau M Trautmann W Schober HG Beger (2002) ArticleTitleCharacteristics of infection with Candida species in patients with necrotizing pancreatitis World J Surg 26 372–6 Occurrence Handle11865377 Occurrence Handle10.1007/s00268-001-0146-9

    Article  PubMed  Google Scholar 

  11. B Gloor CA Muller M Worni PF Stahel C Redaelli W Uhl et al. (2001) ArticleTitlePancreatic infection in severe pancreatitis: the role of fungus and multiresistant organisms Arch Surg 136 592–6 Occurrence Handle11343553 Occurrence Handle10.1001/archsurg.136.5.592 Occurrence Handle1:STN:280:DC%2BD3Mzht1OntQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  12. NJ Greenberger PP Toskes (2001) Acute and Chronic pancreatitis E Braunwald AS Fauci DL Kasper SL Hauser DL Longo JL Jameson (Eds) Harrison's principles and practice of internal medicine EditionNumber15th ed McGraw Hill New York 1792–804

    Google Scholar 

  13. CP Dolan (1971) ArticleTitleA practical approach to identification of yeast like organisms J Clin Pathol 55 580–90 Occurrence Handle1:STN:280:DyaE3M3jtVGqsA%3D%3D

    CAS  Google Scholar 

  14. NC Warren KC Hazen (1999) Candida, Cryptococcus and other yeasts of medical importance PR Murray Degreeseditor in chief EJ Baron MA Pfaller FC Tenover RH Yolken (Eds) Manual of clinical microbiology EditionNumber7th ed ASM Press Washington DC 1184–99

    Google Scholar 

  15. JM Richter GA Jacoby RH Schapiro AL Warshaw (1982) ArticleTitlePancreatic abscess due to Candida albicans Ann Intern Med 97 221–2 Occurrence Handle7049030 Occurrence Handle1:STN:280:DyaL383lsV2ltg%3D%3D

    PubMed  CAS  Google Scholar 

  16. EJ Fitzgerald K Lyons (1986) ArticleTitleCandida abscess of the pancreas: diagnosis and treatment of computed tomography — guided percutaneous drainage Br J Radiol 59 1121–3 Occurrence Handle3790902 Occurrence Handle1:STN:280:DyaL2s%2FnslaqsA%3D%3D Occurrence Handle10.1259/0007-1285-59-707-1121

    Article  PubMed  CAS  Google Scholar 

  17. JM Howard VM Bieluch (1989) ArticleTitlePancreatic abscess secondary to Candida albicans Pancreas 4 120–2 Occurrence Handle2717601 Occurrence Handle1:STN:280:DyaL1M3ktVKgtg%3D%3D Occurrence Handle10.1097/00006676-198902000-00019

    Article  PubMed  CAS  Google Scholar 

  18. N Chia R Clark GT Valainis (1990) ArticleTitleCandida albicans infected pseudocyst in a postpartum woman South Med J 83 687–9 Occurrence Handle2192467 Occurrence Handle10.1097/00007611-199006000-00025 Occurrence Handle1:STN:280:DyaK3c3ovVCqtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  19. PA Reed RM Girgis PS Ashok J Ravi RM Agarwal GJ Brodmerkel SuffixJr (1993) ArticleTitleA pseudocyst infected by Torulopsis glabrata: a unique problem Am J Gastroenterol 88 1962–3 Occurrence Handle8237952 Occurrence Handle1:STN:280:DyaK2c%2Fls1egtg%3D%3D

    PubMed  CAS  Google Scholar 

  20. S Escalante-Glorsky AI Youssef YK Chen (1995) ArticleTitleTorulopsis glabrata infected pancreatic pseudocysts. Diagnosis and treatment J Clin Gastroenterol 21 230–2 Occurrence Handle8648059 Occurrence Handle10.1097/00004836-199510000-00013 Occurrence Handle1:STN:280:DyaK287hs1Sisw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  21. RT Foust (1996) ArticleTitleInfection of a pancreatic pseudocyst due to Candida albicans South Med J 89 1104–7 Occurrence Handle8903299 Occurrence Handle10.1097/00007611-199611000-00018 Occurrence Handle1:STN:280:DyaK2s%2FmtValtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  22. IJ Fedorak TC Ko G Djuricin M McMahon K Thompson RA Prinz (1992) ArticleTitleSecondary pancreatic infection: are they distinct clinical entities? Surgery 112 824–31 Occurrence Handle1411957 Occurrence Handle1:STN:280:DyaK3s%2FjtFamsQ%3D%3D

    PubMed  CAS  Google Scholar 

  23. N Shanmugam R Isenmann JS Barkin HG Berger (2003) ArticleTitlePancreatic fungal infection Pancreas 27 IssueID2 133–8 Occurrence Handle12883261 Occurrence Handle10.1097/00006676-200308000-00005

    Article  PubMed  Google Scholar 

  24. PK Marsh FP Tally J Kellum A Callow SL Gorbach (1983) ArticleTitleCandida infections in surgical patients Ann Surg 198 42–7 Occurrence Handle6407409 Occurrence Handle10.1097/00000658-198307000-00008 Occurrence Handle1:STN:280:DyaL3s3ivF2juw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  25. S Block W Maier R Bittner M Buchler P Malfertheiner HG Beger (1986) ArticleTitleIdentification of pancreas necrosis in severe acute pancreatitis: imaging procedures versus clinical staging Gut 27 1035–42 Occurrence Handle3530895 Occurrence Handle1:STN:280:DyaL2s%2Fgs1Wgtg%3D%3D

    PubMed  CAS  Google Scholar 

  26. HH Stone LD Kolb CA Currie CE Geheber JZ Cuzell (1974) ArticleTitleCandida sepsis: pathogenesis and principle of treatment Ann Surg 179 697–710 Occurrence Handle4207351 Occurrence Handle10.1097/00000658-197405000-00024 Occurrence Handle1:STN:280:DyaE2c7kslCitA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  27. JD Gaines JS Remington (1972) ArticleTitleDisseminated candidiasis in the surgical patient Surgery 72 730–6 Occurrence Handle5080595 Occurrence Handle1:STN:280:DyaE3s%2Fis1Kitw%3D%3D

    PubMed  CAS  Google Scholar 

  28. R Golub F Siddiqi D Pohl (1998) ArticleTitleRole of antibiotics in acute pancreatitis: a metaanalysis J Gastrointest Surg 2 496–503 Occurrence Handle10457308 Occurrence Handle10.1016/S1091-255X(98)80048-6 Occurrence Handle1:STN:280:DyaK1MzptVWjtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  29. A Chakrabarti B Mohan SK Srivastava RSK Marak A Ghosh P Ray (2002) ArticleTitleChange in the distribution and antifungal susceptibility of Candida species isolated from Candidemia cases in tertiary care center during 1996–2000 Indian J Med Res 116 5–12 Occurrence Handle12514972 Occurrence Handle1:CAS:528:DC%2BD3sXit1Wmuw%3D%3D

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Arunaloke Chakrabarti, Pooja Rao, Bansidhar Tarai & Mandya Rudramurthy Shivaprakash

  2. Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Jaidev Wig

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  1. Arunaloke Chakrabarti
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  2. Pooja Rao
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  3. Bansidhar Tarai
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  4. Mandya Rudramurthy Shivaprakash
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  5. Jaidev Wig
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Chakrabarti, A., Rao, P., Tarai, B. et al. Candida in Acute Pancreatitis. Surg Today 37, 207–211 (2007). https://doi.org/10.1007/s00595-006-3371-x

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