Candida albicans Infection Complicating Percutaneous Endoscopic Gastrostomy

Gillanders, I. A.; Davda, N. S.; Danesh, B. J. Z.

doi:10.1055/s-2007-1010571

Cited by 9 publications

(3 citation statements)

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“…Second, an infection with gas-producing microbes following PEG placement has not been described before, although PEG site infections with Candida species have been reported. [8][9][10] Theoretically, the emphysema of the abdominal wall could be a consequence of the pneumoperitoneum, which is regularly seen after PEG insertion. But in this patient, the emphysema could be detected only within the necrotic skin area.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing Candida Infection After Percutaneous Endoscopic Gastrostomy: A Fatal and Rare Complication

Wirth

Bauer

Sieber

2008

J Parenter Enteral Nutr

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Gastrostomy site infections following percutaneous endoscopic gastrostomy (PEG) are the most common complication after PEG placement. Recent meta‐analyses were able to show that PEG site infections can be reduced significantly with a systemic antimicrobial prophylaxis. This mostly cephalosporin‐ or penicillin‐based prophylaxis does not cover fungal infections. Although Candida skin infections after PEG placement are rarely described, a mucosal colonization or infection of the upper GI tract with Candida species is very common, especially in severely ill patients such as those requiring artificial nutrition. The authors report a rare and lethal case of a necrotizing PEG site infection with Candida albicans in a patient with diabetes with multiple comorbidities, presenting like gas gangrene. In patients with probable immunodeficiency or visible candidiasis of the skin, oropharynx, or esophagus, a Candida infection should be considered in case of a gastrostomy site infection.

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Section: Discussionmentioning

confidence: 99%

Necrotizing Candida Infection After Percutaneous Endoscopic Gastrostomy: A Fatal and Rare Complication

Wirth

Bauer

Sieber

2008

J Parenter Enteral Nutr

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“…It has been suggested that intraluminal Candida are environmental contaminants which first colonize the gas trostomy tube and may subsequently infect the patient [1] . We recently investigated the source of this contamination [16].…”

Section: Source Of Intraluminal Candida In Peg Tubesmentioning

confidence: 99%

“…Recently several reports have appeared in the literature [1][2][3] about fungal and bacterial growth in the lumen of feeding tubes. It appears that gastrostomy tubes are an ideal habitat for fungi for the following reasons: 1) regular provision of culture medium, 2) high humidity, 3) temper ature close to 37°C, 4) sanctuary from the body's immune defense, and 5) beyond the reach of antibiotics/antifungals.…”

Section: Introductionmentioning

confidence: 99%

Review: microbiology of the gastrostomy tube.

Gottlieb

Mobarhan

1994

Journal of the American College of Nutrition

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This review summarizes what is presently known about microbial colonization of silicone gastrostomy feeding tubes and their deterioration. Feeding tubes are frequently colonized by fungal and bacterial organisms. Candida organisms seem to originate from the oral cavity from where they colonize the stomach and the gastrostomy tubes. It appears that many microorganisms are able to metabolize certain polymer additives, and although this is well described for polyvinyl chloride, it is not for silicone elastomers. However, clinical evidence for a role of microorganisms in the deterioration of silicone feeding tubes is very strong. The clinical significance of gastrointestinal tract seeding from gastrostomy tubes, which act as incubators, is not fully understood and deserves further study. Likewise, deterioration of feeding tubes must be investigated systematically to address the safety and economical issues it presents.

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Importance of fungus colonization in failure of silicone rubber percutaneous gastrostomy tubes (PEGs)

1996

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Silicone rubber PEG tubes or replacements were recovered from 111 patients and examined for blockage, dilatations, tears, breaks, or loss of elasticity. All irregularities were stained and examined for fungus using lactophenol cotton blue stain. The intraabdominal portion of the PEG failed from obstructions, loss of elasticity, or tears related to fungus colonies in 36% of cases. An additional 34% were colonized with fungi but did not fail. On frozen section, the fungus invaded the wall of the tubing. The extraabdominal PEG tubing failed from fungi in 12, and 10 additional tubes had colonizations. Nine tubes had distal clogging with crystalline material that is believed to arise from medication. Fungus tube failure occurred in 37% of the tubes in place 250 days and in 70% of tubes in place 450 days. Fungus is an important cause of PEG failure; recommendations are provided to maintain tube patency.

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Candida albicans Infection Complicating Percutaneous Endoscopic Gastrostomy

Cited by 9 publications

References 0 publications

Necrotizing Candida Infection After Percutaneous Endoscopic Gastrostomy: A Fatal and Rare Complication

Necrotizing Candida Infection After Percutaneous Endoscopic Gastrostomy: A Fatal and Rare Complication

Review: microbiology of the gastrostomy tube.

Importance of fungus colonization in failure of silicone rubber percutaneous gastrostomy tubes (PEGs)

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