Document Type : Case report
Authors
1
Department of gastroenterology Department of health Abudhabi
2
Department of Internal Medicine, Bronx Care Health System, USA Department of Gastroenterology, MOSC Medical College, India
3
Department of Microbiology, Burjeel Medical City, UAE
4
Department of Radiodiagnosis, Lifecare Hospital, UAE
10.22034/cmm.2026.345367.1627
Abstract
Background and Purpose: Biliary tract infections, particularly cholangitis, pose a significant risk for sepsis, with high morbidity and mortality. Cholangitis is often associated with choledocholithiasis, biliary strictures, and iatrogenic interventions. It is typically bacterial, with Enterobacteriaceae being the most common culprit. Fungal infections of the biliary system are rare, typically occurring in immunosuppressed individuals or in those with foreign biliary devices, such as stents. Candida albicans is the predominant fungal species isolated in biliary infections.
Case presentation: This study aimed to report a case of a middle-aged, apparently immunocompetent male who presented with an acute onset of abdominal pain, fever, and jaundice. Imaging and laboratory investigations revealed features of cholangitis and pancreatitis. Blood and bile cultures yielded Candida albicans, confirming the diagnosis of fungal cholangitis. Notably, the patient had no prior history of immunosuppressive therapy, malignancy, diabetes, or biliary instrumentation. The patient underwent prompt endoscopic retrograde cholangiopancreatography with biliary drainage for source control, followed by targeted antifungal therapy. He demonstrated marked clinical and biochemical improvement, with complete recovery on follow-up.
Conclusion: This case highlights that fungal cholangitis can occur even in immunocompetent individuals without conventional risk factors. Clinicians should maintain a high index of suspicion for fungal pathogens in critically ill patients with cholangitis who are unresponsive to standard antibacterial therapy. Early recognition, timely biliary drainage, and appropriate antifungal management are essential for favorable outcomes. Further studies are warranted to elucidate the role of fungal organisms in biliary tract infections, particularly in immunocompetent individuals, and also to refine diagnostic and therapeutic algorithms for such rare clinical presentations.
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