Mycotic infections of the stomach

Conclusions

• 1. Fungi may cause a gastritis, ulceration and even go on to perforation.

• 2. There are no characteristic symptoms. The complaints are similar to those in functional disturbances of the stomach or in peptic ulcer.

• 3. The diagnosis should be thought of when pathogenic fungi are found in the vomitus. The suspicion should be strengthened when these fungi are found in uncontaminated gastric contents and can also be cultured in appropriate media. Should the inoculation of this culture into a rabbit give a typical reaction and be corroborated by positive blood cultures, intradermal tests and blood agglutinations, a diagnosis of a mycotic infection is warranted.

• 4. The more frequent use of the gastroscope together with increasing skill in recognizing typical mycotic gastritis or ulceration should help to make an early diagnosis possible.

• 5. No reliable prognosis can be given owing to a lack of cases on which to base a definite opinion. There were no complications that could be attributed to the fungi themselves in those cases where operation was performed. If the lesion is due to the ray fungus, the prognosis must be definitely guarded due to the possibility that metastasis to the liver may already be present.

• 6. In uncomplicated cases, iodides to the point of tolerance should be administered. If there are actinomycotic sinuses, then X-ray treatment should also be used.

• 7. For complications such as perforation or repeated hemorrhages, operation is necessary.