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Ann Thorac Surg 2005;80:1120-1122
© 2005 The Society of Thoracic Surgeons

Case report

Fatal Esophageal Perforation Caused by Invasive Candidiasis

Michael Gock, MD, Markus Schäfer, MD, Aurel Perren, MD, Nicolas Demartines, MD, Pierre-Alain Clavien, MD, PhD *

Department of Visceral and Transplantation Surgery, and Pathology, University of Zürich, Zürich, Switzerland

Accepted for publication February 20, 2004.

* Address reprint requests to Dr Clavien, Department of Visceral and Transplantation Surgery, University of Zürich, Rämistr 100, Zürich 8091, Switzerland; (Email: pierre-alain.clavien{at}usz.ch).

Instrumental lesions, spontaneous rupture, and trauma cause most esophageal perforations. Transmural fungal infection is extremely rare, although Candida may be detected in as many as 25% of normal esophagus. In this report we present a case of fatal esophageal perforation due to transmural Candida infection in a 76-year-old woman. The patient died from septic shock and multiorgan failure, despite esophageal resection and systemic antifungal therapy. Pathogenetic aspects and treatment strategies are discussed.






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