# Diagnosis and Treatment Challenges of Candida guilliermondii in Immunocompromised Patients: A Case Study in a Neutropenic AML Patient

## TL;DR

This case study shows how Candida guilliermondii can cause severe intestinal issues in a patient with weakened immunity, emphasizing the need for quick diagnosis and treatment.

## Contribution

The paper presents a novel clinical case highlighting the rare but severe intestinal invasion by Candida guilliermondii in an immunocompromised AML patient.

## Key findings

- Candida guilliermondii was identified as the cause of intestinal necrosis in a neutropenic AML patient.
- Prompt treatment with antifungal and antibiotic therapy was crucial for managing the infection.
- The case underscores the importance of considering fungal infections in immunosuppressed patients with gastrointestinal symptoms.

## Abstract

Although fungal infections causing intestinal perforation and necrosis are rare, they can be particularly dangerous in immunosuppressed patients, often leading to increased mortality rates and poor prognoses. Candida species are typically surface fungi, but in patients with compromised immune systems, they can invade the small intestine and cause angioinvasive infections. A case study involving a 30-year-old female with acute myeloid leukemia (AML) illustrates this phenomenon. The patient was presented with symptoms of abdominal pain, fever, diarrhea, recurrent episodes of intestinal necrosis, hematomas due to thrombocytopenia, and subsequent postoperative enterocutaneous fistulas. Extensive testing ruled out other possible causes of intestinal necrosis and enteritis, including Crohn's and CMV diseases. Candida guilliermondi was ultimately identified in blood cultures from the periphery, peritoneal fluid, and intestinal biopsy of respected sections, indicating that it was responsible for intestinal invasion and necrosis. The patient was then treated with amphotericin B, cefepime, and metronidazole. This case highlights the potential severity of fungal infections in immunosuppressed patients, particularly Candida species, and the importance of prompt diagnosis and appropriate treatment.