消化管真菌症の臨床病理学的検討

概要

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One hundred and ninety-six cases with fungus infections of the digestive tract were encountered in pathological autopsy cases in the Kitasato University Hospital during past 12 years (1971-1983), and were submitted for this study. Its incidence to total autopsy cases was 5.6 percent, and the most of them were determined as terminal infections in cases with malignant tumors and leukemia. The majority of the cases were candidiasis, and a small number of aspergillosis and cryptococcosis were also recognized. Lower part of the esophagus and middle part of the stomach were the most frequently affected sites, and intestinal lesions were low in incidence. Fungal lesions were macroscopically classified into three groups, i.e., erosive, pseudomembranous, and ulcer-associated types. Pseudomembranous type was the predominant lesion of the esophagus, and the ulcer-associated type was most frequent in the stomach. Nausea, vomiting, diarrhea, and gastrointestinal bleeding were common symptons, and their clinical duration was within two weeks in a vast majority of cases with severe fungus infections. It should be mentioned that the lesions of the digestive tract were recognized as the primary focus in most cases with systemic candidiasis.
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