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November 9, 1979

Gastric Candidiasis

Author Affiliations

Centre Hospitalier Universitaire Vaudois Lausanne, Switzerland

JAMA. 1979;242(19):2069-2070. doi:10.1001/jama.1979.03300190011007

To the Editor.—  Candida are commensals of the gastrointestinal tract. Among healthy adults, 30% have Candida in the oral pharynx and 65% in the feces. However, intestinal infections are rare, and gastric infections are even more exceptional. These are related to the alteration in the ratio of bacterial to fungal flora, the increase of glucose concentration in the tissues, and the host's defense mechanisms.The human organism consists essentially of three defense systems against fungi. The first is the natural skin and mucosal barrier. The second is the T-cell-dependent system, and the third is due to antibody-complement-mediated phagocytosis by circulating and fixed phagocytes.Piken et al (240:2181, 1978) described the first reported case of gastric candidosis in a stitch ulcer. The authors presumed that local irritation by the suture material and a low acid output were predisposing causes. A second similar case was reported later (241:791, 1979). Removal of the