A Case of Candida-Associated Intestinal Perforation in a 16-Month Old Child: A Rare Complication of Gastroenteritis with Fatal Outcome

Introduction: Acute gastroenteritis (AGE) remains a leading cause of childhood morbidity and mortality worldwide, predominantly caused by viral, bacterial, or protozoal infections. However, rarely, AGE can be caused by fungus and can result in severe complications, such as intestinal perforation. We report a rare case in a preschool aged child with fatal outcome.

Case presentation: This case report describes a 16-month-old Nigerian girl presenting with acute watery diarrhea, vomiting, and fever. Despite supportive management, including fluid resuscitation, antibiotics, and probiotics, her condition deteriorated, with progressive abdominal distension and desaturation. Abdominal X-ray revealed intestinal perforation, and stool culture identified Candida species as the etiologic agent. Unfortunately, delayed antifungal therapy and surgical intervention led to a fatal outcome.

Conclusion: This case highlights Candida as a rare but life-threatening cause of intestinal perforation in immunocompetent children. It underscores the importance of early diagnosis identification and judicious use of antimotility agents in managing AGE. Clinicians should maintain a high index of suspicion for fungal gastroenteritis in cases of persistent or worsening symptoms.