Hirasaki S, Koide N, Ogawa H, Tsuji T
First Department of Internal Medicine, Okayama University School of Medicine, Japan.
J Gastroenterol. 1999 Dec;34(6):688-93. doi: 10.1007/s005350050320.
A case of benign gastric ulcer associated with Candida infection in a healthy adult is reported. The patient was a 46-year-old man complaining of epigastralgia. Endoscopic examination of the upper digestive tract revealed an elevated lesion with ulceration having an unclear border and thick exudates. The clinical diagnosis based on endoscopic findings was a benign gastric ulcer; however, biopsy was performed to distinguish it from malignant lymphoma. Histological examination of biopsy samples obtained from the base and the edge of the ulcer revealed numerous Candida. Therefore, the patient was diagnosed with Candida-infected gastric ulcer. The ulcer resolved after the administration of antiulcer drugs for 2 months. Predisposing factors for fungal infection were excluded. These observations suggest that Candida-infected gastric ulcer should be suspected in patients with a gastric submucosal tumor-like lesion with a thick, yellowish-white coated ulcer of unclear border on its summit, and this lesion should be distinguished from malignant diseases.
报告了一例健康成年男性良性胃溃疡合并念珠菌感染的病例。患者为一名46岁男性,主诉上腹部疼痛。上消化道内镜检查发现一个隆起性病变,伴有边界不清的溃疡和厚的渗出物。基于内镜检查结果的临床诊断为良性胃溃疡;然而,为了将其与恶性淋巴瘤区分开来,进行了活检。对从溃疡底部和边缘获取的活检样本进行组织学检查,发现大量念珠菌。因此,该患者被诊断为念珠菌感染性胃溃疡。给予抗溃疡药物治疗2个月后溃疡愈合。排除了真菌感染的诱发因素。这些观察结果表明,对于胃黏膜下肿瘤样病变且顶部有边界不清的厚黄白色覆盖溃疡的患者,应怀疑念珠菌感染性胃溃疡,并且该病变应与恶性疾病相鉴别。