Esophageal candidiasis differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
Esophageal candidiasis should be differentiated from other diseases causing dysphagia especially in immunocompromised patients. | Esophageal candidiasis should be differentiated from other diseases causing [[dysphagia]] especially in [[Immunocompromised|immunocompromised patients]]. | ||
==Differentiating esophageal candidiasis from other diseases== | ==Differentiating esophageal candidiasis from other diseases== | ||
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|Candida esophagitis | |Candida esophagitis | ||
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* Odynophagia is the most prominent symptom | * [[Odynophagia]] is the most prominent symptom | ||
* May be accompanied by oropharyngeal candidiasis | * May be accompanied by [[oropharyngeal candidiasis]] | ||
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* Endoscopy shows characteristic white yellowish lesions over the mucosa. | * [[Endoscopy]] shows characteristic white yellowish lesions over the [[Mucous membrane|mucosa.]] | ||
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|HSV esophagitis | |[[HSV|HSV esophagitis]] | ||
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* HSV esophagitis is due to reactivation of HSV usually in immunocompromised patients. | * [[HSV|HSV esophagitis]] is due to reactivation of [[HSV]] usually in [[Immunocompromised|immunocompromised patients]]. | ||
* HSV esophagitis usually presents acutely as dysphagia, odynophagia accompanied by fever and other constitutional symptoms. | * [[HSV|HSV esophagitis]] usually presents acutely as [[dysphagia]], [[odynophagia]] accompanied by [[fever]] and other constitutional symptoms. | ||
* Oropharyngeal vesicles and ulcers may accompany HSV esophagitis.<ref name="pmid8686361">{{cite journal |vauthors=Becker K, Lübke HJ, Borchard F, Häussinger D |title=[Inflammatory esophageal diseases caused by herpes simplex virus infections--overview and report of 15 personal cases] |language=German |journal=Z Gastroenterol |volume=34 |issue=5 |pages=286–95 |year=1996 |pmid=8686361 |doi= |url=}}</ref> | * [[Vesicles|Oropharyngeal vesicles]] and [[ulcers]] may accompany [[HSV|HSV esophagitis]].<ref name="pmid8686361">{{cite journal |vauthors=Becker K, Lübke HJ, Borchard F, Häussinger D |title=[Inflammatory esophageal diseases caused by herpes simplex virus infections--overview and report of 15 personal cases] |language=German |journal=Z Gastroenterol |volume=34 |issue=5 |pages=286–95 |year=1996 |pmid=8686361 |doi= |url=}}</ref> | ||
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* HSV lesions are usually present in the distal esophagus. Lesions start as vesicles but later on coalesce and form large ulcers. | * [[HSV]] lesions are usually present in the distal esophagus. Lesions start as [[vesicles]] but later on coalesce and form large [[ulcers]]. | ||
* Ulcers are 8-10 mm in size, has a volcano like appearance and covered with a white exudate. | * [[Ulcers]] are 8-10 mm in size, has a volcano like appearance and covered with a white exudate. | ||
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|CMV esophagitis | |[[CMV esophagitis (patient information)|CMV esophagitis]] | ||
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* CMV esophagitis is characterized by more insidious onset of nausea, vomiting, dysphagia and consequent weight loss. | * [[CMV esophagitis (patient information)|CMV esophagitis]] is characterized by more insidious onset of [[nausea]], [[vomiting]], [[dysphagia]] and consequent [[weight loss]]. | ||
* CMV esophagitis occurs more commonly in organ transplant patients more than in HIV patients. | * [[CMV esophagitis (patient information)|CMV esophagitis]] occurs more commonly in [[organ transplant]] patients more than in [[Human Immunodeficiency Virus (HIV)|HIV]] patients. | ||
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* As in HSV esophagitis, CMV lesions are usually in the distal esophagus. | * As in [[HSV|HSV esophagitis]], [[CMV]] lesions are usually in the distal esophagus. | ||
* Lesions can be multiple small ulcers or large single shallow ulcer. | * Lesions can be multiple small [[ulcers]] or large single shallow ulcer. | ||
* CMV esophagitis can present as esophageal necrosis with no ulcers.<ref name="pmid2823585">{{cite journal |vauthors=Balthazar EJ, Megibow AJ, Hulnick D, Cho KC, Beranbaum E |title=Cytomegalovirus esophagitis in AIDS: radiographic features in 16 patients |journal=AJR Am J Roentgenol |volume=149 |issue=5 |pages=919–23 |year=1987 |pmid=2823585 |doi=10.2214/ajr.149.5.919 |url=}}</ref> | * [[CMV]] esophagitis can present as [[Necrosis|esophageal necrosis]] with no ulcers.<ref name="pmid2823585">{{cite journal |vauthors=Balthazar EJ, Megibow AJ, Hulnick D, Cho KC, Beranbaum E |title=Cytomegalovirus esophagitis in AIDS: radiographic features in 16 patients |journal=AJR Am J Roentgenol |volume=149 |issue=5 |pages=919–23 |year=1987 |pmid=2823585 |doi=10.2214/ajr.149.5.919 |url=}}</ref> | ||
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|Esophageal lymphoma | |[[Lymphoma|Esophageal lymphoma]] | ||
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* Esophageal lymphoma has nonspecific symptoms of dysphagia, hoarseness and | * [[Lymphoma|Esophageal lymphoma]] has nonspecific symptoms of [[dysphagia]], [[hoarseness]] and [[Chest pain|retrosternal chest pain]]. | ||
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* Endoscopy is useful in obtaining biopsies as visual findings are not specific as lymphoma can be accompanied by candidiasis or HSV esophagitis.<ref name="pmid21160688">{{cite journal |vauthors=Ghimire P, Wu GY, Zhu L |title=Primary esophageal lymphoma in immunocompetent patients: Two case reports and literature review |journal=World J Radiol |volume=2 |issue=8 |pages=334–8 |year=2010 |pmid=21160688 |pmc=2999330 |doi=10.4329/wjr.v2.i8.334 |url=}}</ref> | * [[Endoscopy]] is useful in obtaining [[biopsies]] as visual findings are not specific as [[lymphoma]] can be accompanied by [[candidiasis]] or [[HSV|HSV esophagitis]].<ref name="pmid21160688">{{cite journal |vauthors=Ghimire P, Wu GY, Zhu L |title=Primary esophageal lymphoma in immunocompetent patients: Two case reports and literature review |journal=World J Radiol |volume=2 |issue=8 |pages=334–8 |year=2010 |pmid=21160688 |pmc=2999330 |doi=10.4329/wjr.v2.i8.334 |url=}}</ref> | ||
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Revision as of 04:09, 27 May 2017
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Esophageal candidiasis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Esophageal candidiasis differential diagnosis On the Web |
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American Roentgen Ray Society Images of Esophageal candidiasis differential diagnosis |
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Risk calculators and risk factors for Esophageal candidiasis differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]
Overview
Esophageal candidiasis should be differentiated from other diseases causing dysphagia especially in immunocompromised patients.
Differentiating esophageal candidiasis from other diseases
| Prominent clinical featurs | Endoscopy findings | ||
|---|---|---|---|
| Candida esophagitis |
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| HSV esophagitis |
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| CMV esophagitis |
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| Esophageal lymphoma |
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Candida esophagitis should also be differentiated from other causes of dysphagia as:
- Gastroesophageal reflux disease (GERD)
- Barrett's esophagus
- Esophageal achalasia
- Pill esophagitis
- Eosinophilic esophagitis
References
- ↑ Becker K, Lübke HJ, Borchard F, Häussinger D (1996). "[Inflammatory esophageal diseases caused by herpes simplex virus infections--overview and report of 15 personal cases]". Z Gastroenterol (in German). 34 (5): 286–95. PMID 8686361.
- ↑ Balthazar EJ, Megibow AJ, Hulnick D, Cho KC, Beranbaum E (1987). "Cytomegalovirus esophagitis in AIDS: radiographic features in 16 patients". AJR Am J Roentgenol. 149 (5): 919–23. doi:10.2214/ajr.149.5.919. PMID 2823585.
- ↑ Ghimire P, Wu GY, Zhu L (2010). "Primary esophageal lymphoma in immunocompetent patients: Two case reports and literature review". World J Radiol. 2 (8): 334–8. doi:10.4329/wjr.v2.i8.334. PMC 2999330. PMID 21160688.