A Study on Ten Cases of Deep Fungus Infection after Gastroenterological Surgery -With Special Reference to the Infectious Risk Index-

Yoshihiro Asanuma, Yutaka Shibata, Hideaki Andoh, Noriaki Sasaki, Takashi Saitoh, Kenji Koyama

The First Department of Surgery, Akita University School of Medicine

Ten cases of deep fungus infection after gastroenterological surgery were analyzed in terms of infectious risk index and serological examination for candidemia, namely, CAND-TEC. The infectious risk index, calculated using numbers of neutrophilis, lymphocytes and leukocytes, was as high as 54 in one case, but lower than 20 in the other 9 cases. In leukemia and malignant lymphoma patients, impaired cellular immunity is reportedly an important contributing factor for the establishment of opportunistic fungus infections because of the high infectious risk index. However, in patients who undergo gastroenterological surgery, the increased opportunity for fungal infection due to operative insult on the intestine and tissues is the main causative factor in combination with the change in microflora caused by the administration of multiple antibiotics. In all cases, Candida antigen titer was positive at a level of 1:2 or greater titer. It became negative in the 7 survivors, but was unchanged or increased in 3 dead cases. CAND-TEC is useful for the diagnosis of candidemia and judgement of the efficacy of antifungal treatment.

Key words
deep fungus infection, infectious risk index of the fungus

Reprint requests
Yoshihiro Asanuma The First Department of Surgery, Akita University School of Medicine
1-1-1 Hondo, Akita, 010 JAPAN

Accepted
July 7, 1993

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