Antifungal Therapy for Complicated Intra-Abdominal Infection: A Case Report

Authors

  • Mega Halida Universitas Indonesia
  • Vera Irawany Universitas Indonesia
  • Adhrie Sugiarto Universitas Indonesia

DOI:

https://doi.org/10.59141/-.v8i2.537

Keywords:

Complicated Intra-Abdominal Infection, Antifungal Therapy, Candida Infection, Fluconazole, Critical Care

Abstract

Complicated intra-abdominal infection (cIAI) is a serious condition characterized by the extension of infection beyond the gastrointestinal tract into the peritoneal cavity and is associated with high morbidity and mortality. Management of cIAI requires a comprehensive approach, including prompt diagnosis, adequate source control, and appropriate antimicrobial therapy. This case report describes the role of antifungal therapy in the management of cIAI in a critically ill patient with multiple risk factors for invasive fungal infection. A 52-year-old woman with a history of cervical cancer treated with radiotherapy and chronic hemodialysis presented with abdominal pain, nausea, vomiting, and inability to tolerate oral intake. Diagnostic evaluation revealed obstructive ileus and necrotic ileal tissue requiring exploratory laparotomy and intestinal resection. Postoperatively, the patient was admitted to the intensive care unit and received broad-spectrum antibiotics combined with fluconazole as empirical antifungal therapy. Clinical and laboratory improvements were observed during intensive care management, leading to stabilization and subsequent transfer to a high-dependency unit. This case highlights the importance of considering antifungal therapy in healthcare-associated intra-abdominal infections, particularly among immunocompromised and critically ill patients at risk of Candida infection. Early recognition, adequate source control, and individualized antimicrobial selection remain essential for optimizing patient outcomes.

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References

Abdulmomen, A. A., AlZahrani, A. S., Al Mulla, L. A., & Alaqeel, F. O. (2022). Acute perforated appendicitis associated with appendiceal diverticulitis in a young man: a case report with literature review. The American Journal of Case Reports, 23, e934838-1.

Abubakar, U., Zulkarnain, A. I., Rodríguez-Baño, J., Kamarudin, N., Elrggal, M. E., Elnaem, M. H., & Harun, S. N. (2022). Treatments and predictors of mortality for carbapenem-resistant gram-negative bacilli infections in Malaysia: a retrospective cohort study. Tropical Medicine and Infectious Disease, 7(12), 415.

Balada-Llasat, J.-M., Stamas, N., Vincent, T., Timbrook, T. T., Saiontz-Martinez, C., Hemmert, R. B., & Berger, A. (2022). Epidemiology and economic outcomes associated with timely versus delayed receipt of appropriate antibiotic therapy among US patients hospitalized for native septic arthritis: a retrospective cohort study. Antibiotics, 11(12), 1732.

Barie, P. S., Kao, L. S., Moody, M., & Sawyer, R. G. (2023). Infection or inflammation: are uncomplicated acute appendicitis, acute cholecystitis, and acute diverticulitis infectious diseases? Surgical Infections, 24(2), 99–111.

Bova, R., Griggio, G., Vallicelli, C., Santandrea, G., Coccolini, F., Ansaloni, L., Sartelli, M., Agnoletti, V., Bravi, F., & Catena, F. (2024). Source control and antibiotics in intra-abdominal infections. Antibiotics, 13(8), 776.

Dayan, G. S., Bahig, H., Johnson-Obaseki, S., Eskander, A., Hong, X., Chandarana, S., De Almeida, J. R., Nichols, A. C., Hier, M., & Belzile, M. (2023). Oncologic significance of therapeutic delays in patients with oral cavity cancer. JAMA Otolaryngology–Head & Neck Surgery, 149(11), 961–969.

Devine, E. E., & Forrester, J. D. (n.d.). Intra-abdominal infections in the immunocompromised. GLOBAL INFECTION PREVENTION AND MANAGEMENT IN HEALTHCARE, 322.

Hagiwara, J., Yoshioka, K., Ito-Hagiwara, K., Endo, Y., Jafari, D., Rolston, D. M., Kuschner, C. E., Becker, L. B., & Hayashida, K. (2026). Optimizing infection management after cardiac arrest: addressing diagnostic uncertainty and therapeutic dilemmas—a narrative review. Journal of Intensive Care, 14(1), 20.

Kayembe, J.-M. N., & Kayembe, H.-C. N. (2025). Challenges of Early Diagnosis and Effective Treatment of Pneumonia in Resource-Limited Settings. In Viral Infectious Diseases Annual Volume 2025. IntechOpen.

Kiekkas, P., Tzenalis, A., Gklava, V., Stefanopoulos, N., Voyagis, G., & Aretha, D. (2022). Delayed admission to the intensive care unit and mortality of critically ill adults: Systematic review and meta‐analysis. BioMed Research International, 2022(1), 4083494.

Kryvoruchko, I. A., Usenko, O. Y., Lurin, I. A., & Ivanova, Y. V. (2024). Diagnosis of intra-abdominal infections. GLOBAL INFECTION PREVENTION AND MANAGEMENT IN HEALTHCARE, 275.

Maity, S., Leton, N., Nayak, N., Jha, A., Anand, N., Thompson, K., Boothe, D., Cromer, A., Garcia, Y., & Al-Islam, A. (2024). A systematic review of diabetic foot infections: pathogenesis, diagnosis, and management strategies. Frontiers in Clinical Diabetes and Healthcare, 5, 1393309.

Mekakas, A., & Nagorni, E.-A. (2022). Complicated Appendicitis: A Surgical Controversy Concerning. Doubts, Problems and Certainties about Acute Appendicitis, 65.

Monnet, X., Messina, A., Greco, M., Bakker, J., Aissaoui, N., Cecconi, M., Coppalini, G., De Backer, D., Edul, V. K., & Evans, L. (2025). ESICM guidelines on circulatory shock and hemodynamic monitoring 2025. Intensive Care Medicine, 51(11), 1971–2012.

Napolitano, L. M. (2022). Intra-abdominal infections. Seminars in Respiratory and Critical Care Medicine, 43(01), 10–27.

Potey, K., Kandi, A., Jadhav, S., & Gowda, V. (2023). Study of outcomes of perforated appendicitis in adults: a prospective cohort study. Annals of Medicine and Surgery, 85(4), 694.

Sartelli, M., Barie, P., Agnoletti, V., Al-Hasan, M. N., Ansaloni, L., Biffl, W., Buonomo, L., Blot, S., Cheadle, W. G., & Coimbra, R. (2024). Intra-abdominal infections survival guide: a position statement by the Global Alliance For Infections In Surgery. World Journal of Emergency Surgery, 19(1), 22.

Sartelli, M., Palmieri, M., & Labricciosa, F. M. (2025). Antibiotics for intra-abdominal infections: When, which, how and how long? Antibiotics, 14(11), 1127.

Sartelli, M., Tascini, C., Coccolini, F., Dellai, F., Ansaloni, L., Antonelli, M., Bartoletti, M., Bassetti, M., Boncagni, F., & Carlini, M. (2024). Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use. World Journal of Emergency Surgery, 19(1), 23.

Sejersen, K., Sütterlin, S., & Larsson, A. O. (2026). Disease-Causing Mechanisms and Therapeutic Targets in Infectious Diseases: Implications for Clinical Management and Public Health. Biomedicines, 14(3), 694.

Tenforde, M. W., Noah, K. P., O’Halloran, A. C., Kirley, P. D., Hoover, C., Alden, N. B., Armistead, I., Meek, J., Yousey-Hindes, K., & Openo, K. P. (2025). Timing of influenza antiviral therapy and risk of death in adults hospitalized with influenza-associated pneumonia, influenza hospitalization surveillance network (FluSurv-NET), 2012–2019. Clinical Infectious Diseases, 80(2), 461–468.

Vonny, V., Oktaliansah, E., & Erlangga, M. E. (2026). Comprehensive Intensive Care Management of Sepsis Secondary to Submandibular Abscess Complicated by Ventilator-Associated Pneumonia. Journal of Society Medicine, 5(1), 23–30.

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Published

2026-08-05

How to Cite

Halida, M., Irawany , V., & Sugiarto , A. (2026). Antifungal Therapy for Complicated Intra-Abdominal Infection: A Case Report. Jurnal Sehat Indonesia (JUSINDO), 8(2), 642–647. https://doi.org/10.59141/-.v8i2.537