Candida Infection Complicating Peptic Esophageal Ulcer:  Infection in an Aortic-Esophageal Fistula

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