Small Intestinal Fungal Overgrowth Mimicking a Surgical Abdomen and Presenting as Bowel Obstruction: A Case Report and Literature Review.

Small intestinal fungal overgrowth (SIFO) is defined by an abnormal proliferation of fungal organisms, most commonly Candida species, within the small intestine. Fungal infections, particularly candidiasis, are recognized causes of gastrointestinal (GI) symptoms, especially in patients with underlying conditions, such as malignancy or diabetes mellitus (DM), and in those exposed to immunosuppressive therapies, corticosteroids, or prolonged antibiotic use. SIFO is an underrecognized cause of GI symptoms, including bloating, diarrhea, and malabsorption. In rare cases, excessive fungal colonization can lead to mechanical bowel obstruction. This case report describes a patient with advanced retroviral infection who developed small bowel obstruction secondary to SIFO, underscoring the diagnostic challenges, therapeutic approaches, and the critical importance of early recognition and management.