title: Invasive candidal enterocolitis followed shortly by fatal cerebral hemorrhage in immunocompromised patients.
abstract: Two immunocompromised adult patients (male, 43 years of age; female, 50 years of age) are described who developed unusual and similarly unique complications. After chemotherapy, both presented with abdominal pain and severe bloody diarrhea. Initial blood cultures were negative, and abdominal CT showed pneumatosis and thickening of colonic wall. Colonoscopy showed severe right-sided colitis. Relentless bloody diarrhea necessitated emergency right hemicolectomy in both cases. Pathologic examination of the specimens showed extensive and severe hematogenous Candida enterocolitis. Both patients died of acute cerebral hemorrhage within 3 days of hemicolectomy. Autopsy, performed on 1 of the 2 cases, showed diffuse severe cerebritis and cerebral hemorrhage secondary to hematogenous invasive candidiasis. This sequence of events is not documented in the English literature on candidal enterocolitis, which is reviewed.
authors.affiliation: Department of Pathology, Rush University Medical Center, Chicago, IL 60612, USA. David_J_Cimbaluk@rush.edu
authors.forename: David
authors.initials: D
authors.lastname: Cimbaluk
authors.forename: Jennifer
authors.initials: J
authors.lastname: Scudiere
authors.forename: John
authors.initials: J
authors.lastname: Butsch
authors.forename: Shriram
authors.initials: S
authors.lastname: Jakate
mesh_terms: D000328:Adult; D002177:Candidiasis / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D003113:Colonoscopy; D004760:Enterocolitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed