Coexistence of diffuse malignant peritoneal mesothelioma and Candida norvegensis peritonitis

Our plain-English summary of Coexistence of diffuse malignant peritoneal mesothelioma and Candida norvegensis peritonitis, by E. Virgilio, P. Mercantini, M. Ferri, et al (Surgical Infections, 2014).

The study

• Authors: E. Virgilio, P. Mercantini, M. Ferri, M. Cavallini, A. Teggi, V. Ziparo
• Journal: Surgical Infections
• Published: 2014;15(5):660-1
• Type of article: Case report, Letter
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor described one patient and briefly reviewed published reports. In 2007, a 54-year-old man was admitted to a hospital in Rome, Italy, with a high fever of three weeks' duration that common oral antibiotics had not relieved. A CT scan showed a small amount of fluid around the liver and thickening of the lining of the right side of the abdomen. The yeast Candida norvegensis was grown from his blood and abdominal fluid, and abnormal cancer-type cells were found in the fluid. After fluconazole and then itraconazole failed, oral voriconazole brought his temperature to normal within one week. At exploratory surgery, the abdominal membranes looked thickened and gelatinous, and tissue removed showed diffuse malignant peritoneal mesothelioma. He received chemotherapy but died of the cancer two months after surgery. The article did not mention asbestos or any work history. The authors called this the first case of this cancer heralded by persistent high fever with proved C. norvegensis peritonitis. They urged doctors to consider this fungal infection in feverish patients with this cancer.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report of a single patient, published as a letter to the editor, with a brief review of the literature
• Who was studied: One 54-year-old man admitted in 2007 to the Division of Infectious Diseases of the authors' hospital in Rome, Italy
• Exposure: Not reported. The article does not mention asbestos, any fiber type, or the patient's occupation. It describes his medical history as unrewarding.
• Main results:
  • On admission the patient had a leukocyte count of 18,400/mm3 with 85.5% neutrophils, hemoglobin of 7.2 g/dL, C-reactive protein of 403.5 mg/dL and an erythrocyte sedimentation rate of 140 mm/h. Tests for HIV, hepatitis B and C and several other infections were negative.
  • CT showed modest fluid around the liver (perihepatic ascites) and diffuse thickening of the right anterolateral parietal peritoneum.
  • Candida norvegensis was isolated from blood and ascites. Paracentesis also retrieved some neoplastic cells.
  • After fluconazole and itraconazole failed, oral voriconazole (200 mg twice daily) normalized body temperature within one week.
  • At exploratory laparoscopy, all serous membranes appeared thickened, hyperemic and gelatinous. Omentectomy was performed, and histology showed diffuse malignant peritoneal mesothelioma.
  • Systemic chemotherapy was started, but the patient deteriorated and died of the cancer two months after surgery.
• The authors' conclusion: The authors concluded that this was the first case of diffuse malignant peritoneal mesothelioma heralded by persistent high-grade fever associated with proved C. norvegensis peritonitis. They invited infectious disease specialists, oncologists and oncologic surgeons to consider this fungal peritonitis in febrile patients with this cancer.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma.

Related studies

• Peritoneal malignant mesothelioma in a patient with recurrent peritonitis — R.H. Riddell, M.J. Goodman, et al. (1981)
• CT differentiation of malignant peritoneal mesothelioma and tuberculous peritonitis — W.J. Yin, G.Q. Zheng, et al. (2016)
• Clinical picture, response to therapy, and survival of women with diffuse malignant peritoneal mesothelioma — G.H. Eltabbakh, M.S. Piver, et al. (1999)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Multi-institutional experience of diffuse intra-abdominal multicystic peritoneal mesothelioma — T.C. Chua, T.D. Yan, et al. (2011)
• Diffuse malignant peritoneal mesothelioma--an update on treatment — P. Mirarabshahii, K. Pillai, et al. (2012)

Browse return to medical research.