An Unusual Case of Acute Abdomen: Candida-Associated Jejunal Perforation With Pancolitis in an Immunocompetent Patient

Gastrointestinal candidiasis is typically encountered in immunocompromised individuals. Small bowel perforation presenting in association with pancolitis in an immunocompetent patient is exceedingly rare. We report the case of a 67-year-old immunocompetent male patient who presented with acute abdomen and generalized peritonitis. Emergency exploratory laparotomy revealed a jejunal perforation 10 cm distal to the duodenojejunal flexure, which was managed with primary repair and an omental patch. The postoperative course was initially uneventful; however, the patient was readmitted with diarrhea and abdominal pain. Imaging revealed diffuse pancolitis with terminal ileal involvement. Histopathological examination of the jejunal perforation edge biopsy demonstrated fungal elements in the form of pseudohyphae and budding yeast forms consistent with Candida species, without evidence of malignancy or granulomatous disease. The patient responded favorably to systemic antifungal therapy with fluconazole. This case highlights a rare presentation of Candida-associated jejunal perforation with pancolitis in an immunocompetent patient and underscores the importance of routine histopathological evaluation in hollow viscus perforation and early consideration of fungal etiology in atypical postoperative gastrointestinal presentations.