Symptomatic Plaque Form Gastric Candidiasis in a Patient with Chronic Kidney Disease

Abstract

Non oesophageal gastrointestinal candida infection is not common and tends to present with single or multiple ulcerations containing candida deep in the ulcer beds. Gastric ulcers associated with candida tend to be larger in diameter and often suspected to be malignant than typical gastric ulcers. Pseudomembrane formation or white plaque deposits without ulceration may be seen uncommonly on endoscopy of the stomach. We report the occurrence of diffuse plaque deposits of candida in the gastric antrum of a 36 year old female patient with chronic kidney disease (CKD) on maintenance haemodialysis who presented with epigastric pain, nausea, vomiting and passage of black stools for two weeks. Upper gastrointestinal endoscopy revealed diffuse whitish candida plaque deposits over the gastric antrum with no ulceration or concomitant oesophageal involvement. She responded well to antifungal therapy with resolution of symptoms. This case demonstrates the occurrence of gastric candidiasis in CKD patient on haemodialysis, and highlights the significance of upper gastrointestinal endoscopy in the evaluation and management of CKD patients with dyspeptic symptoms.