Esophageal candidiasis overview
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 is an opportunistic infection of the esophagus by Candida albicans. The disease occurs in patients in immunocompromised states, including post-chemotherapy and in AIDS. It is also known as candidal esophagitis or monilial esophagitis
Historical Perspective
Pathophysiology
Causes
C. albicans is the main species causing infection in humans more than any other candida species.
Differentiating esophageal candidiasis from other diseases
Esophageal candidiasis should be differentiated from other diseases causing dysphagia especially in immunocompromised patients.
Classification
Epidemiology and Demographics
Candidiasis is the most common cause of infectious esophagitis followed by HSV esophagitis.
Risk Factors
Immunodeficiency is the most important risk factor for candida esophagitis.
Screening
Natural History, Complications and Prognosis
Candida esophagitis is very responsive to antifungal therapy. Complications can be systemic due to the spread of infection to the blood stream or local as esophageal stricture and obstruction.
Symptoms and Physical Examination
The underlying predisposing factors are usually clear on obtaining history (HIV, chemotherapy, etc ..). Odynophagia is the most common encountered symptom of esophageal candidiasis. Examination reveals signs of immunocompromisation that was the primary cause of developing esophageal thrush.
Diagnostic tests
Although the appearance of the patches during endoscopy is diagnostic for esophageal candidiasis, biopsies should be obtained to confirm the diagnosis. If patient is not already diagnosed with HIV or another immunocompromising disease, screening should be done.