Candida-associated gastric ulcer relapsing in a different position with a different appearance.

World J Gastroenterol. 2012 Aug 28;18(32):4450-3.

Sasaki K.

Department of Gastroenterology, Tsuboi Cancer Center Hospital, 1-10-13, Nagakubo, Asakamachi, Koriyama, Fukushima, 963-0197, Japan

Abstract

An 87-year-old, Japanese woman was shown to have a submucosal tumor-like lesion with a deep, central ulceration covered with thick, whitish exudate in the stomach. Biopsy showed Candida tropicalis but not Helicobacter pylori (H. pylori). She had no predisposing factors or history of peptic ulcers nor had taken non-steroidal anti-inflammatory drugs (NSAIDs), diagnosed with Candida-associated gastric ulcer. Though cured of the lesion, she developed another ulcer in a different position, in which Candida was demonstrated but H. pylori was undetectable. This is the first case of recurrent Candida-associated gastric ulcer in the world. Detected in both the original and recurrent lesions in an H. pylori-negative patient with no antecedent ulcers who had not taken NSAIDs, Candida is considered, contrary to the prevailing opinion, to play an etiologic role in ulcer formation.

PMID: 22969213

Supplementary pictures:

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Figure 1 Endoscopic photograph showing a medium-sized, SMT-like elevation with an oval, deep, central ulceration covered with thick, whitish exudate on the greater curvature of the upper gastric body.

 

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Figure 2 Light micrograph of the biopsied specimen of the lesion in Fig. 1 demonsrating hyphae in the ulcer slough (PAS/diastase, original magnification x400)

 

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Figure 3 Endoscopic photograph showing a recurrent ulcer on the lesser curvature of the lower gastric body.

 

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Figure 4 Light micrograph of the biopsied specimen of the recurrent ulcer demonstrating hyphae of Candida in the ulcer edge (PAS/diastase, original magnification x400).

 

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