Sudden Esophageal Necrosis and Mediastinitis Associated with Invasive Candidiasis: A Case Report

Abstract

Patient: Male, 35-year-old Final Diagnosis: Esophageal perforation Symptoms: Emesis Medication:— Clinical Procedure: — Specialty: Critical Care Medicine Objective: Rare disease Background: Esophageal necrosis is a rare entity characterized by the presence of extensive circumferential necrosis of the esophagus. It generally affects older adults who have associated chronic pathologies and has a reported mortality rate of approximately 32%. Most patients with esophageal necrosis have a complex clinical course. Case Report: We present the case of a 37-year-old man with idiopathic chronic renal failure who presented to the Emergency Department with sudden esophageal necrosis and mediastinitis, associated with invasive candidiasis. Diagnosis was challenging owing to the rarity of the condition. The patient required intensive care management and multiple surgical procedures. Conclusions: Esophageal necrosis is an uncommon pathology that can be fatal because of associated complications. Its pathophysiology is unclear, and its treatment is based on the control of local injury and signs and symptoms. Acute esophageal necrosis associated with invasive Candida sp. infection is even more infrequent, with only a few cases reported in the literature.

A rare case of combined black esophagus and stomach: a case report

“…However, the patients in these reports did not have pan-esophageal necrosis, and in most cases only the distal esophagus was involved. A report by Riascos and colleagues demonstrated a case of near pan-esophageal necrosis with perforation ( 11 ). The patient underwent a left cervicotomy and right thoracotomy with wide mediastinal drainage for source control initially, followed by return to operating room (OR) for esophagectomy and feeding gastrostomy several days after improved hemodynamics.…”

„Black esophagus“ – zwei Obduktionsfälle mit infektiöser Beteiligung

“…Dabei handelte es sich um Viren wie das Herpes-simplex-Virus [2] oder das Zytomegalie-Virus [7], Bakterien wie Klebsiella pneumoniae [8] oder Lactobacillus acidophilus [9] und Pil-ze [10] wie Penicillium chrysogenum [11]. Ein Zusammenhang mit einer Kandidose wurde bislang in der englischsprachigen Literatur nur in wenigen Fällen genannt [2,[12][13][14], obwohl die Candida-Infektion des Magen-Darm-Trakts keine Rarität ist.…”