Proposed Treatment of Adjustable Intragastric Balloon Contaminated with Candida

Introduction: The intragastric balloon (IB) can be indicated for patients with overweight and obesity refractory to behavioral and medical treatment. In unusual situations, fungal colonization of the IB is observed, sometimes on their content, asymptomatic in most cases. The rare incidence of colonization is presented as the result of a multifactorial involvement, which predisposes to opportunistic infections. Case Report: Thirty-seven year old obese female, 87.5kg, and body mass index 35kg/m(2). An adjustable intragastric balloon was indicated for treating obesity. At the end of the second month of treatment, she started presenting epigastric pain, postprandial fullness, and vomiting. The computed tomography showed abnormal balloon inflation, with air inside. The management adopted was to carry out total evacuation of the adjustable balloon, followed by new insufflation with nystatin solution added to methylene blue solution. Discussion: The contamination of the IB and its content raises the possibility of gas production inside the balloon by fungal fermentation, resulting in increased balloon volume leading to obstructive symptoms. In these situations, typically the balloon is removed and pharmacologic treatment is not necessary. In this case, it was shown well succeeded by no recurrence of hyperinflation with gas.