Parasitic and mycotic causes of biliary obstruction

Abstract

Five cases of parasitic and mycotic infection affecting the biliary tract are reported. Special attention is paid to the radiological presentation of chlonorchiasis, ascariasis, echinococcosis, and candidiasis of the biliary tract. Each entity is briefly described, and the differential diagnosis and specific radiological patterns are discussed. Biliary tract manipulation with a balloon catheter and endoprosthesis is presented as an option for management of the biliary obstruction in some cases.

Liver and Bile Duct Infections

“…369 Candidal infection of the biliary tree and gallbladder occurs in disseminated candidiasis, with bacterial cholangitis, or as isolated candidal cholangitis or cholecystitis. 373,374 Candida species can be identified from liver biopsies using PCR techniques, which may be useful in cases in which patients are on antifungal treatment and organisms are not identified by pathologic examination. 375…”

“…They may eventually cause dull abdominal pain and a palpable mass. 374 Abdominal ultrasound is key for the diagnosis of cystic echinoccocosis and further classifies the cysts as active, transitional, or inactive based on a classification scheme developed by the World Health Organization (WHO) which helps to guide management. 440 Serologic testing is available but has low sensitivity and is used primarily as a confirmatory test.…”

Bottled Lemon Juice -- A Cryptic Source of Invasive Candida Infections in the Immunocompromised Host

“…Lemonjuice wasfound to be the likelyvehicle of Candida infections in these patients [2][3][4][5][6]; Candida spp, grow welland even selectively in lemon juice [2][3][4][5].…”

“…Bottled Lemon Juice -A Cryptic Source of Inwsive Candida Infections in tbe Immunocompromised Host COLLEAGUES -Wefollowed with interestthe recent discussion in the Journal of disseminatedcandidiasisin heroin abusers [1][2][3]. Lemonjuice wasfound to be the likelyvehicle of Candida infections in these patients [2][3][4][5][6]; Candida spp, grow welland even selectively in lemon juice [2][3][4][5].…”

“…This fact has prompted many investigators throughout the years to develop several strategies for preventing these infections. Some of the most commonly known strategies include the use of antibiotic prophylaxis; the continuous bacteriologic surveillanceof skin, throat, and stool; diet changes, especiallyin regard to salads and juices; the avoidance of fresh flowersand carpets; better teeth-brushing methods and care of the mouth and anus; and the avoidance of waterrelated activities [2,3).…”