# Invasive Gastric Candidiasis With Concurrent Clostridioides difficile Colitis: A Case Report and Review of the Literature

## TL;DR

This case report describes an elderly man with rare invasive gastric candidiasis and Clostridioides difficile colitis, highlighting the complex interactions between fungal infections and gut health.

## Contribution

The novelty lies in presenting a rare concurrent case of invasive gastric candidiasis and C. difficile colitis, emphasizing their interplay and diagnostic challenges.

## Key findings

- Invasive gastric candidiasis can present with upper gastrointestinal bleeding from gastric ulcers.
- Concurrent C. difficile colitis may complicate fungal infections in elderly patients.
- Antibiotic use and gut barrier disruption contribute to worsening infectious disease.

## Abstract

Invasive gastric candidiasis is a rare fungal infection of the stomach, often arising in the setting of immunosuppression, critical illness, mucosal barrier disruption, gut microbial alterations, or antibiotic use. Though Candida spp. are normal flora within the gastrointestinal tract, compromised host defenses can contribute to overgrowth and invasion of the fungal species into deeper tissues. We report a case of an 89-year-old man presenting with concurrent upper gastrointestinal bleeding from diffuse gastric ulcers secondary to invasive gastric candidiasis and diarrhea resulting from Clostridioides difficile colitis. The pathophysiology, diagnosis, and management of invasive candidiasis as well as interactions between gastrointestinal candidiasis and Clostridioides difficile infection are discussed. Overall, this case highlights the interplay between antibiotic use, gut barrier translocation, interactions between microorganisms, and worsening infectious disease in an elderly patient. Similarly, it stresses the importance of maintaining a high index of suspicion for fungal infections in patients with large atypical appearing gastric ulcers, even in the absence of overt immunosuppression.