In the present patient extreme debility and prolonged antibiotic therapy were probably the most important factors in the development of systemic candidiasis. Latterly the progress of the disease may have been accelerated by cortisone therapy and by intravenous administration of 20% glucose saline. Indeed, Duhig and Mead (1951) and Schaberg and his colleagues regarded the prolonged use of intravenous glucose saline as an important factor in establishing the infection in theircases. Some form of injection appears to be common to all cases of systemic candidiasis irrespective of the use of antibiotics. Here, however, infection from the alimentary tract may have occurred at operation, since local peritoneal exudate infected with C. tropicalis was present between the stomach and liver at necropsy. Systemic candidiasis has been reported after duodenal perforation or abdominal operations on a number of occasions (Brown et al.; Schaberg et al.; Caplan, 1955; Matthias and Rees; Barrett et al.).
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H. G. Richmond (1959) studied this question.
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