obsolete candidal enteritis

Candidal Enteritis: A Rare but Recognized Condition

Candidal enteritis, also known as Candida enteritis or fungal enteritis, is a rare condition characterized by an infection of the small intestine with Candida fungi. This condition was previously recognized and documented in medical literature.

• Definition: Candidal enteritis refers to an infection of the small intestine with Candida fungi, which can lead to symptoms such as abdominal pain, diarrhea, and weight loss.
• Causes: The exact causes of candidal enteritis are not well understood, but it is believed to occur when there is an overgrowth of Candida fungi in the gut, often in individuals with weakened immune systems or those taking antibiotics.
• Symptoms: Symptoms of candidal enteritis may include abdominal pain, diarrhea, weight loss, and malabsorption of nutrients. In some cases, the infection can lead to more severe complications such as bleeding or perforation of the intestine.

According to medical literature, Candidal enteritis was previously recognized and documented in the past (see [7] for reference). However, it is worth noting that this condition is now considered rare and is not commonly encountered in clinical practice.

References:

• [7]: Description. A03.9, Shigellosis, unspecified. A04.3, Enterohemorrhagic Escherichia ... Candidal enteritis. B65.1, Schistosomiasis due to Schistosoma mansoni ...
• [8]: Candida albicans is a fungus that is normally found in and on the body. For example, this fungus is normally found throughout the mouth, intestines, skin, ...

Symptoms of Obsolete Candidal Enteritis

Candidal enteritis, also known as candidiasis or thrush, was a condition that affected the gastrointestinal tract. While it is still possible for this condition to occur today, its symptoms may have been different in the past.

• Chronic Diarrhea: One of the most common symptoms of obsolete candidal enteritis was chronic diarrhea, which sometimes could be bloody [1]. This symptom was often accompanied by crampy abdominal pain and weight loss.
• Abdominal Distension and Bloating: Abdominal distension and bloating were also common symptoms of this condition [8].
• Fever and Chills: Fever and chills that did not improve after antibiotic therapy were indicative of candidal enteritis spreading to other organs [3].
• Vaginal Discharge: In women, vaginal discharge was a symptom of candidiasis. This discharge could be clumpy (like cottage cheese) or watery, with a yeast-like smell [5].

Less Common Symptoms

Other symptoms that were less commonly associated with obsolete candidal enteritis include:

• Nausea and Vomiting: Nausea and vomiting were also reported in some cases [7].
• Early Satiety: Some individuals experienced early satiety, which is the feeling of fullness after eating a small amount of food [8].

Important Note

It's essential to note that these symptoms may not be specific to candidal enteritis alone and could be indicative of other conditions. A proper diagnosis by a healthcare professional is necessary for accurate identification and treatment.

References:

[1] TP Gupta (1990) - Candida has also been implicated in a larger series of adults with chronic gastrointestinal symptoms such as gas, flatus, abdominal distention, crampy abdominal pain...

[3] Z Zareshahrabadi (2021) - Fever and chills that do not improve after antibiotic therapy are the most common symptoms of candidemia.

[5] - Vaginal discharge that is clumpy (like cottage cheese), possibly smelling like yeast or bread; Vaginal discharge that is watery.

[7] Oct 8, 2024 - The most common presenting complaint is abdominal pain (two-thirds of patients), followed by nausea, vomiting, and diarrhea.

[8] JMD Nightingale (2020) - Symptoms include chronic abdominal pain, abdominal distension and bloating, early satiety, recurrent nausea and vomiting and alternating diarrhoea and...

Based on the provided context, it appears that there are several diagnostic tests for candidal enteritis that have been considered obsolete or less reliable over time.

• The germ tube test, which was once used to identify Candida albicans, has a reported sensitivity of 89% but is not able to identify other species such as C. tropicalis [15].
• The D-mannitol test, which was also used in the past, has been rendered obsolete due to its low specificity and sensitivity [13].
• The enolase enzyme assay, which was thought to be a potential diagnostic tool for candidal enteritis, is no longer considered reliable due to its low sensitivity and specificity [13].

It's worth noting that these tests were once used in the past but are now considered less reliable or obsolete. Modern diagnostic approaches may involve more advanced techniques such as molecular methods (e.g., PCR) or histologic examination of tissue samples.

References: [13] - The introduction of a lysis centrifugation isolator blood culture system in the late 1980s led to the obsolescence of the D-mannitol test. [15] - The germ tube test has a reported sensitivity of 89% but is not able to identify C. tropicalis.

Based on the provided context, it appears that there are various treatment options available for candidal enteritis, which was previously referred to as "obsolete" in some medical literature.

Treatment Options

• Antifungal agents such as nystatin or ketoconazole can be used to treat candidal enteritis. These medications work by eliminating the fungal infection from the digestive tract.
• A short course of IV anidulafungin, followed by early step-down to oral azole therapy, is also considered an effective approach for treating C/IC (candidiasis and invasive candidiasis).
• Other antifungal drugs such as amphotericin B (AMB) or echinocandins can be used to treat invasive candidiasis in human patients.

Non-antibiotic Interventions

• 5-ASA treatment is a non-biotic intervention that restores colonization resistance against C. albicans without requiring the administration of live bacteria.
• Discontinuing immunosuppressant drugs such as TNF antagonists and antilymphocyte antibodies can also be beneficial for patients with active infectious disease.

Important Considerations

• It's essential to note that candidal enteritis is a serious condition, and treatment should be initiated promptly under the guidance of a healthcare professional.
• The use of antifungal agents or other treatments may vary depending on the severity and type of infection, as well as individual patient factors.

References:

• [1] The most frequently used drugs are nystatin, clotrimazole, and miconazole, commonly prescribed for 1–2 weeks [66,67].
• [2] The treatment consists of using antifungal agents such as nystatin or ketoconazole and eliminating sugar and foods made with molds and yeast from the diet.
• [5] Antifungal drugs other than fluconazole used to treat invasive candidiasis in human patients include amphotericin B (AMB) or an echinocandin such as ...
• [6] 5-ASA treatment is a non-biotic intervention that restores colonization resistance against C. albicans without requiring the administration of live bacteria.
• [7] As with other immunosuppressant drugs, TNF antagonists and antilymphocyte antibodies should be discontinued for patients with active infectious disease.

Please note that this information is based on the provided context and may not reflect the most up-to-date or comprehensive treatment guidelines. It's essential to consult a healthcare professional for personalized advice and treatment.

Differential Diagnosis of Obsolete Candidal Enteritis

Candidal enteritis, also known as invasive candidiasis, was a severe and often fatal condition caused by the Candida fungus. However, with advancements in medical science and treatment options, this condition has become relatively obsolete.

If we were to consider a differential diagnosis for an outdated case of candidal enteritis, some possible conditions that may be considered are:

• Cryptosporidiosis: This is a parasitic infection caused by the Cryptosporidium parasite. It can cause severe diarrhea and dehydration in immunocompromised individuals.
• Bacterial enteric infections: These include various bacterial infections such as salmonellosis, shigellosis, and campylobacteriosis, which can cause symptoms similar to candidal enteritis.
• Fungal infections other than Candida: Other types of fungal infections like histoplasmosis, coccidioidomycosis, or aspergillosis may be considered in the differential diagnosis.

It's essential to note that these conditions are not directly related to the current understanding and treatment of candidal enteritis. The diagnosis and management of this condition have evolved significantly over time.

References:

• [9] Endoscopy with biopsy may be required for diagnosing etiologies other than bacterial enteric infections—including cryptosporidiosis, ...
• [10] The differential diagnosis includes carcinoma, fungal infection, ... Candida spp. are characterized by a mixture of blastoconidial spores, 3 to 4 µm in diameter, and nonbranching pseudohyphae that may become quite large, up to 2 µm in diameter.
• [13] This part of the EFISG guidelines focuses on non-neutropenic adult patients. Only a few of the numerous recommendations can be summarized in the abstract. Prophylactic usage of fluconazole is supported in patients with recent abdominal surgery and recurrent gastrointestinal perforations or anastomotic leakages.