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Outcome and management of invasive candidiasis following oesophageal perforation.
- Source :
-
Mycoses . Mar2013, Vol. 56 Issue 2, p173-178. 6p. 1 Color Photograph, 1 Black and White Photograph, 5 Charts. - Publication Year :
- 2013
-
Abstract
- The regular colonisation of the oesophagus with a Candida species can, after oesophageal perforation, result in a contamination of the mediastinum and the pleura with a Candida species. A patient cohort of 80 patients with oesophageal perforation between 1986 and 2010 was analysed retrospectively. The most common sources with positive results for Candida were mediastinal biopsies and broncho-alveolar secretions. Candida species were detected in 30% of the patients. The mortality rate was 41% in patients with positive microbiology results for Candida, whereas it was 23% in the remaining patient cohort. This difference did not reach statistical significance ( P = 0.124). Mortality associated with oesophageal perforation was attributed mainly to septic complications, such as mediastinitis and severe pneumonia. During the study period we observed a shift towards non-albicans species that were less susceptible or resistant to fluconazole. In selected patients with risk factors as immunosuppression, granulocytopenia and long-term intensive-care treatment together with the finding of Candida, an antimycotic therapy should be started. A surgical approach offers the possibility to obtain deep tissue biopsies. The antimycotic therapy should start with an echinocandin, as the resistance to fluconazole is growing and to cover non-albicans Candida species, too. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09337407
- Volume :
- 56
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Mycoses
- Publication Type :
- Academic Journal
- Accession number :
- 85747173
- Full Text :
- https://doi.org/10.1111/j.1439-0507.2012.02229.x