Assessment of Infection of the Intestine in Three Patients and a Systematic Review of Case Reports.

BACKGROUND

Hematogenous dissemination of can result in multiorgan involvement (skin, lung, and reticuloendothelial system involvement); however, few studies have reported intestinal infections. We investigated clinical features, management, and patient outcomes concerning -related intestinal infections.

METHODS

Patients with between August 2012 and April 2019 at The First Affiliated Hospital of Guangxi Medical University, China, were retrospectively analyzed. Patients presenting with intestinal and endoscopy-confirmed diagnoses were investigated. We also undertook a systematic review of the relevant English and Chinese literature.

RESULTS

Of 175 patients diagnosed with , 33 presented with gastrointestinal symptoms, and 31 underwent stool cultures, 1 of which tested positive. Three patients had gastrointestinal symptoms and negative stool cultures, and endoscopic tissue biopsy confirmed a pathological diagnosis. A systematic review of 14 reports on human identified an additional 16 patients. Fever, weight loss, and anemia were the most common symptoms, along with abdominal pain, diarrhea, and bloody stools. Abdominal computed tomography showed intestinal wall edema and thickening and/or abdominal lymphadenopathy. Endoscopy showed erosion, hyperemia, edema, and multiple intestinal mucosal ulcers. Of the 19 patients, 16 received antifungal therapy, 14 of whom recovered and 2 died. Three patients received no therapy and died.

CONCLUSIONS

Gastrointestinal disseminated is not rare and can affect the stomach, duodenum, and colon, and may involve the entire digestive tract. Colon is the most common site. Endoscopy is needed for patients presenting with gastrointestinal symptoms in infected endemic areas. Systemic application of effective antifungal therapy can improve the prognosis.