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Journal of Case Reports
Candida Diarrhoea in a Patient of Nephrotic Syndrome

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Ashima Jain, Shalini Malhotra, Akash Das, Preeti Madan, Nirmaljeet Kaur
From the Department of Microbiology, PGIMER & Dr. Ram Manohar Lohia Hospital, Baba Kharak Singh Marg, New Delhi-110001, India.
Corresponding Author:
Dr. Ashima Jain
Email: ashimajain15@gmail.com
Received: 03-OCT-2014 Accepted: 13-NOV-2014 Published Online: 05-DEC-2014
DOI: http://dx.doi.org/10.17659/01.2014.0120
Abstract
Nephrotic syndrome is considered to be an immunosuppressive condition and hence, is associated with increased prevalence of superimposed infections. We report a case of 7 year old child suffering from nephrotic syndrome who presented with fever, swelling all over the body and pain abdomen. The child contracted diarrhoea after 3 days of stay in hospital. On stool examination, eggs of Hymenolepis nana, cysts of Giardia lamblia and budding yeast cells along with pseudohyphae were seen. Culture grew Candida albicans. Since the diarrhoea was not relieved even after treating the parasitic infection, Candida was considered to be the pathogen. The child was administered fluconazole for 2 weeks which helped in recovery from the diarrhoea. Candida sp. is considered to be frequent commensal of the gastrointestinal tract. However, since our patient was empirically started on multiple antibiotics, which is a known risk factor for Candida diarrhea, the probability of Candida being the enteropathogen was high, considering that antibiotic therapy facilitates proliferation of Candida in the intestine. Hence, the significance of Candida in stool sample should always be assessed by correlating with other relevant history and it should not always be dismissed as being a commensal.
Keywords : Candida, Candida albicans, Cysts, Fluconazole, Nephrotic Syndrome, Giardia lamblia, Humans.
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