Gupta T P, Ehrinpreis M N
Division of Gastroenterology, Wayne State University School of Medicine, Detroit, Michigan.
Gastroenterology. 1990 Mar;98(3):780-5. doi: 10.1016/0016-5085(90)90303-i.
Ten hospitalized patients with severe diarrhea associated with intestinal Candida overgrowth are reported. Candida-associated diarrhea is predominantly of the secretory type, characterized by frequent watery stools, usually without blood, mucus, tenesmus, or abdominal pain. The patients were elderly, malnourished, and critically ill, or suffered from chronic debilitating illness. Their hospital stays were prolonged, and the majority were being treated with multiple antibiotics or chemotherapeutic agents. Diarrhea often led to dehydration, prerenal azotemia, hyperchloremic metabolic acidosis, and electrolyte imbalance. Stool culture most frequently isolated Cand. albicans in association with decreased normal flora. Colonoscopy showed no evidence of colitis. Diagnosis was made based on the absence of diarrhea-producing medications, the continuation of diarrhea despite fasting, the exclusion of other infections, inflammatory conditions and other causes of secretory diarrhea, and a dramatic response to a short course of nystatin.
报告了10例因肠道念珠菌过度生长而伴有严重腹泻的住院患者。念珠菌相关性腹泻主要为分泌型，其特征为频繁水样便，通常无血、黏液、里急后重或腹痛。这些患者年龄较大、营养不良且病情危重，或患有慢性消耗性疾病。他们的住院时间延长，大多数患者正在接受多种抗生素或化疗药物治疗。腹泻常导致脱水、肾前性氮质血症、高氯性代谢性酸中毒和电解质失衡。粪便培养最常分离出白色念珠菌，同时正常菌群减少。结肠镜检查未发现结肠炎证据。诊断依据为无导致腹泻的药物、禁食后腹泻仍持续、排除其他感染、炎症性疾病及其他分泌性腹泻原因，以及对短疗程制霉菌素治疗有显著反应。
