Candida-associated diarrhea in hospitalized patients

Gastroenterology. 1990 Mar;98(3):780-5. doi: 10.1016/0016-5085(90)90303-i.

Abstract

Ten hospitalized patients with severe diarrhea associated with intestinal Candida overgrowth are reported. Candida-associated diarrhea is predominantly of the secretory type, characterized by frequent watery stools, usually without blood, mucus, tenesmus, or abdominal pain. The patients were elderly, malnourished, and critically ill, or suffered from chronic debilitating illness. Their hospital stays were prolonged, and the majority were being treated with multiple antibiotics or chemotherapeutic agents. Diarrhea often led to dehydration, prerenal azotemia, hyperchloremic metabolic acidosis, and electrolyte imbalance. Stool culture most frequently isolated Cand. albicans in association with decreased normal flora. Colonoscopy showed no evidence of colitis. Diagnosis was made based on the absence of diarrhea-producing medications, the continuation of diarrhea despite fasting, the exclusion of other infections, inflammatory conditions and other causes of secretory diarrhea, and a dramatic response to a short course of nystatin.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Candida / isolation & purification
  • Candidiasis / complications*
  • Candidiasis / drug therapy
  • Candidiasis / microbiology
  • Chronic Disease
  • Cross Infection / complications*
  • Cross Infection / drug therapy
  • Cross Infection / microbiology
  • Diarrhea / drug therapy
  • Diarrhea / etiology*
  • Diarrhea / microbiology
  • Drug Therapy, Combination
  • Feces / microbiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutrition Disorders / complications
  • Nutrition Disorders / microbiology
  • Nystatin / therapeutic use

Substances

  • Nystatin