Candida Infection Complicating Peptic Esophageal Ulcer

Abstract
Communication between the esophagus and the aorta occurs uncommonly. The usual cause is trauma 1 incurred by the ingestion of a foreign body, or less often by surgery or penetrating chest wound. Another prominent cause of aortic-esophageal fistulae is carcinoma of the esophagus.2 Aortic-esophageal fistulae are usually located at the level of the aortic arch 1 where these two structures are approximated most closely. The present communication presents what seems to be a unique situation. A patient who was trained in esophageal speech after total laryngectomy developed a hiatus hernia with peptic ulceration at the esophageal-gastric junction. This ulcer penetrated posteriorly into the aorta and produced fatal massive hematemesis through the resultant aortic-esophageal fistula. At postmortem examination yeast-like organisms, morphologically characteristic of Candida, were found in the wall of the aorta along the fistulous tract. Report of a Case A 62-year-old white man was admitted to the West Haven

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